Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov 16;10(11):348-353.
doi: 10.4253/wjge.v10.i11.348.

Submucosal injection of platelet-rich plasma in endoscopic resection of large sessile lesions

Vicente Lorenzo-Zúñiga  1 , Vicente Moreno de Vega  2 , Ramón Bartolí  2 , Ingrid Marín  2 , Noemí Caballero  2 , Ignacio Bon  2 , Jaume Boix  2
Affiliations

Submucosal injection of platelet-rich plasma in endoscopic resection of large sessile lesions

Vicente Lorenzo-Zúñiga et al. World J Gastrointest Endosc. .

Abstract

Aim: To prospectively evaluate the efficacy of submucosal injection of platelet-rich plasma (PRP) on endoscopic resection of large sessile lesions.

Methods: Eleven patients were submitted to endoscopic mucosal resection (EMR) with prior injection of PRP, obtained at the time of endoscopy. Patients were followed during 1 mo. The incidence of adverse events (delayed bleeding or perforation) and the percentage of mucosal healing (MHR) after 4 wk were registered.

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%).

Conclusion: PRP is an easy-to-obtain solution with proven and favourable biological activities that could be used in advanced endoscopic resection.

Keywords: Endoscopic mucosal resection; Large lesions; Platelet-rich plasma; Submucosal injection.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: The authors of this manuscript having no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Patient flow-chart. EMR: Endoscopic mucosal resection; PRP: Platelet-rich plasma.
Figure 2
Figure 2
Preparation of platelet-rich plasma. A: Olin-1 Kit; B: Centrifugation of peripheral blood; C: PRP; D: Activation of PRP. PRP: Platelet-rich plasma.
Figure 3
Figure 3
Mean ulcerated area and mucosal healing rate were calculated by the use of ImageJ public software (Image Processing and Analysis in Java. https://imagej.nih.gov/ij).
Figure 4
Figure 4
Mucosal healing after endoscopic resection in two patients treated with submucosal injection of platelet-rich plasma at baseline and after 4 wk. A: Patient 1 at baseline; B: Patient 1 at week 4; C: Patient 2 at baseline; D: Patient 2 at week 4.
See this image and copyright information in PMC

References

    1. Ferlitsch M, Moss A, Hassan C, Bhandari P, Dumonceau JM, Paspatis G, Jover R, Langner C, Bronzwaer M, Nalankilli K, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2017;49:270–297. - PubMed
    1. Burgess NG, Metz AJ, Williams SJ, Singh R, Tam W, Hourigan LF, Zanati SA, Brown GJ, Sonson R, Bourke MJ. Risk factors for intraprocedural and clinically significant delayed bleeding after wide-field endoscopic mucosal resection of large colonic lesions. Clin Gastroenterol Hepatol. 2014;12:651–61.e1-3. - PubMed
    1. Hassan C, Repici A, Sharma P, Correale L, Zullo A, Bretthauer M, Senore C, Spada C, Bellisario C, Bhandari P, et al. Efficacy and safety of endoscopic resection of large colorectal polyps: a systematic review and meta-analysis. Gut. 2016;65:806–820. - PubMed
    1. Albéniz E, Fraile M, Ibáñez B, Alonso-Aguirre P, Martínez-Ares D, Soto S, Gargallo CJ, Ramos Zabala F, Álvarez MA, Rodríguez-Sánchez J, et al. A Scoring System to Determine Risk of Delayed Bleeding After Endoscopic Mucosal Resection of Large Colorectal Lesions. Clin Gastroenterol Hepatol. 2016;14:1140–1147. - PubMed
    1. Liaquat H, Rohn E, Rex DK. Prophylactic clip closure reduced the risk of delayed postpolypectomy hemorrhage: experience in 277 clipped large sessile or flat colorectal lesions and 247 control lesions. Gastrointest Endosc. 2013;77:401–407. - PubMed