Prospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Nov 16, 2018; 10(11): 348-353
Published online Nov 16, 2018. doi: 10.4253/wjge.v10.i11.348
Submucosal injection of platelet-rich plasma in endoscopic resection of large sessile lesions
Vicente Lorenzo-Zúñiga, Vicente Moreno de Vega, Ramón Bartolí, Ingrid Marín, Noemí Caballero, Ignacio Bon, Jaume Boix
Vicente Lorenzo-Zúñiga, Vicente Moreno de Vega, Ramón Bartolí, Ingrid Marín, Noemí Caballero, Ignacio Bon, Jaume Boix, Department of Gastrointestinal Endoscopy, University Hospital Germans Trias/CIBERehd, Barcelona 08916, Spain
Author contributions: Lorenzo-Zúñiga V, Moreno de Vega V and Boix J contributed to the design of the study and performed the colonoscopies; Lorenzo-Zúñiga V and Bartolí R performed the data analysis and wrote the document; Marín I, Caballero N, and Bon I have revised the manuscript.
Institutional review board statement: The study was reviewed and approved by the institutional review board and Ethics Committee of University Hospital Germans Trias.
Informed consent statement: All study participants provided written consent prior to study enrolment.
Clinical trial registration: Study registered at ClinicalTrials.gov: NCT02931149.
Conflict-of-interest statement: The authors of this manuscript having no conflicts of interest to disclose.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Vicente Lorenzo-Zúñiga, MD, Professor, Department of Gastrointestinal Endoscopy, University Hospital Germans Trias, Carretera del Canyet s/n, Badalona 08916, Spain. vlorenzo.germanstrias@gencat.cat
Telephone: 00-34-934978866
Received: May 12, 2018
Peer-review started: May 12, 2018
First decision: July 9, 2018
Revised: August 8, 2018
Accepted: October 8, 2018
Article in press: October 10, 2018
Published online: November 16, 2018
ARTICLE HIGHLIGHTS
Research background

Submucosal injection of fluid solutions is crucial to prevent of adverse events in endoscopic resections. Platelet-rich plasma (PRP) has demonstrated strong healing properties in preclinical models.

Research motivation

PRP solution proved excellent electrical and rheological properties to perform safety endoscopic resections. PRP could be an ideal lifting solution in therapeutic endoscopy.

Research objectives

The primary outcome was the assessment of the incidence of adverse events (delayed bleeding or delayed perforation). Secondary objective was the evaluation of mucosal healing rate (MHR), calculated as a percentage of mucosal restoration after 1 mo.

Research methods

This was a non-randomized prospective single-center study (ClinicalTrials.gov NCT02931149). Subjects eligible for the study were men and women aged 18 and older who were submitted for endoscopic resection (EMR) of sessile lesions larger than 35 mm. Patients were allocated to receive PRP as submucosal injection of PRP prior to EMR.

Research results

EMR was performed in 11 lesions (46.4 mm± 4 mm, range 40-70 mm). Delayed bleeding or perforation was not observed in any patient. Mean ulcerated area at baseline was 22.7 cm2 ± 11.7 cm2 whereas at week 4 were 2.9 cm2 ± 1.5 cm2. Patients treated with PRP showed a very high MHR after 4 wk (87.5%).

Research conclusions

The new finding of this study is that PRP is lifting solution with proven and favourable biological activities that could be used in advanced endoscopic resection.

Research perspectives

We need larger studies to validate these findings and to perform a comparison study with other lifting solutions.