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Comparative Study
. 2009 Sep;23(9):2094-101.
doi: 10.1007/s00464-008-0207-3. Epub 2008 Dec 5.

Different solutions used for submucosal injection influenced early healing of gastric endoscopic mucosal resection in a preclinical study in experimental pigs

Jan Bures  1 , Marcela Kopácová, Jaroslav Kvetina, Jan Osterreicher, Zuzana Sinkorová, Zbynek Svoboda, Ilja Tachecí, Stanislav Filip, Stanislav Spelda, Martin Kunes, Stanislav Rejchrt
Affiliations
Comparative Study

Different solutions used for submucosal injection influenced early healing of gastric endoscopic mucosal resection in a preclinical study in experimental pigs

Jan Bures et al. Surg Endosc. 2009 Sep.

Abstract

Background: We hypothesised that different solutions for submucosal injection may influence early healing of endoscopic mucosal resection (EMR). The aim of this study was to evaluate histological and immunological changes after EMR in experimental pigs.

Materials and methods: Two parallel EMRs on the anterior and posterior wall of the gastric body were performed by means of the cap technique in 21 female pigs. A glycerol-based solution (anterior EMR) and hydroxypropyl methylcellulose solution (posterior EMR) were applied for submucosal injection. The animals were sacrificed 7 days later, and tissue sections of all EMRs were stained using combined trichrome. Computer image analysis was used for objective evaluation of elastic and collagen fibres content. Two-colour indirect immunophenotyping of blood and gastric samples were performed using mouse anti-pig monoclonal antibodies.

Results: The values of collagen fibre content 7 days after EMR were significantly higher in lesions after the use of solution A in comparison with solution B (2.10 +/- 0.25% versus 1.57 +/- 0.25%, p = 0.009). Concordant results were found in elastic fibres (3.23 +/- 0.49% versus 2.93 +/- 0.61%, p = 0.018). No systemic changes in major leukocyte subpopulations were found. In gastric tissue, lymphocyte subsets exhibited only minor changes. CD4(+) T-lymphocytes were increased in the healing tissue after EMR using solution A (17.08 +/- 9.24% versus 9.76 +/- 7.97%, p = 0.011). Significant increase of SWC3(+) leukocytes was observed after EMR using solution B (47.70 +/- 25.41% versus 18.70 +/- 12.16%, p = 0.001).

Conclusions: The use of glycerol-based solution for submucosal injection was associated with more pronounced histological signs of early healing of EMRs compared with hydroxypropyl methylcellulose.

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Figures

Fig. 1
Fig. 1
Representative view of two healing lesions 7 days after EMRs. The posterior wall is on the left and the anterior one on the right. Submucosal tattooing by suspension of highly purified carbon particles is marked by an asterisk
Fig. 2
Fig. 2
Detailed view of granulous tissue (magnification 600×) 7 days after EMR in the stomach (solution A). Elastic fibres are bright violet (arrows). Combined trichrome (green trichrome with Orange Q) staining
Fig. 3
Fig. 3
Detailed view of granulous tissue (magnification 600×) 7 days after EMR in the stomach (solution B). Elastic fibres are bright violet (arrows). Combined trichrome (green trichrome with Orange Q) staining
Fig. 4
Fig. 4
Inverted image of Fig. 2, demonstrating numerous collagen fibres in dark brown (arrows)
Fig. 5
Fig. 5
Inverted image of Fig. 3, demonstrating numerous collagen fibers in dark brown (arrows)
See this image and copyright information in PMC

References

    1. Soetikno RM, Gotoda T, Nakanishi Y, Soehendra N (2003) Endoscopic mucosal resection. Gastrointest Endosc 57:567–579 - DOI - PubMed
    1. Tada M, Murata M, Murakami F (1984) Development of strip-off biopsy (in Japanese with English abstract). Gastroenterol Endosc 26:833–839
    1. Inoue H, Takeshita K, Hori H, Muraoka Y, Yoneshima H, Endo M (1993) Endoscopic mucosal resection with a cap-fitted panendoscope for esophagus, stomach, and colon mucosal lesions. Gastrointest Endosc 39:58–62 - DOI - PubMed
    1. Tanabe S, Koizumi W, Kokutou M, Imaizumi H, Ishii K, Kida M, Yokoyama Y, Ohida M, Saigenji K, Shimao H, Mitomi H (1999) Usefulness of endoscopic aspiration mucosectomy as compared with strip biopsy for the treatment of gastric mucosal cancer. Gastrointest Endosc 50:819–822 - DOI - PubMed
    1. Shim C-S (2001) Endoscopic mucosal resection: an overview of the value of different techniques. Endoscopy 33:271–275 - DOI - PubMed

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