Published online Nov 16, 2018. doi: 10.4253/wjge.v10.i11.348
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
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.
PRP solution proved excellent electrical and rheological properties to perform safety endoscopic resections. PRP could be an ideal lifting solution in therapeutic endoscopy.
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.
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.
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%).
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.
We need larger studies to validate these findings and to perform a comparison study with other lifting solutions.