Abstract

COMPARATIVE STUDY OF VARIOUS SOLUTIONS FOR ENDOSCOPIC SUBMUCOSAL INJECTION: A PORCINE STOMACH MODEL

Kitti Chuenyong* and Kanokpoj Chanpiwat

Abstract

Purpose: To study the mean duration of mucosal elevation (DME) of four different solutions in an ex-vivo porcine stomach model. Inter-investigator variations in DME values were also investigated. Patients and Methods: Four injectates, namely NSS, glyceol, 25% glucose and 50% glucose, were used. A total volume of 1 mL of each solution was injected into one 4x4 cm square gastric piece. The injections were administered by two investigators independently, and VDO recordings by digital camera were made at the time of each injection. Durations of mucosal elevation (DME) were recorded and analyzed. Results: A total of 10 specimens per solution per investigator were utilised, so that 80 pieces of porcine gastric pieces were used in all. The DME of NSS, glyceol, 25% glucose and 50% glucose were 103.26, 76.87, 66.78 and 48.49 min respectively. Only NSS and 50% glucose were significantly different. No difference was detected in DME values of the two investigators. Conclusion: NSS had the longest DME in our ex-vivo porcine stomach model, and this was contrary to the findings of some in-vivo studies. We found that the ex-vivo porcine stomach models were not appropriate for comparing the duration of the submucosal cushion from various injectates; an in-vivo live animal model would be better.

Keywords: Submucosal injection, fluid cushion, endoscopic mucosal resection, polypectomy, porcine stomach, injectate.