Application Research of Sodium Hyaluronate in Endoscopic Submucosal Tunnel Resection (STER) for Esophageal Cancer
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v4i4.1468
Abstract
Objective: This study aims to evaluate the efficacy and safety of submucosal injection using a mixture containing sodium hyaluronate in submucosal tunneling endoscopic resection (STER) for esophageal submucosal tumors (SMTs). Methods: A total of 42 patients with SMTs participated in this study from January 2020 to October 2023. The patients were randomly divided into the experimental group (n=21) and the control group (n=21). The experimental group received a mixture of 5ml sodium hyaluronate injection (50mg) + 25ml fructose sodium chloride injection + 0.1ml methylene blue injection as submucosal injection. The control group received 30ml fructose sodium chloride injection + 0.1ml methylene blue injection. Submucosal injection started 5cm proximal to the SMT in the esophagus using the mixture until effective mucosal elevation for subsequent STER surgery. Results: There was no statistically significant difference in the average diameter of resected specimens between the experimental group (1.9±1.3 cm) and the control group (2.0±1.1cm, P>0.05). The average operation time in the experimental group (70.05±9.93 min) was significantly shorter than the control group (96.29±12.15 min, P<0.05). The average submucosal injection volume in the experimental group (13.52±2.77ml) was significantly lower than the control group (26.38±3.47ml, P<0.05). In cases with bleeding <5ml, the experimental group had 18 cases (86%), while the control group had 4 cases (19%); in cases with bleeding >5ml, the experimental group had 3 cases (14%), and the control group had 17 cases (81%), showing a statistically significant difference (P<0.05). Conclusion: Submucosal injection using a mixture containing sodium hyaluronate for STER surgery not only exhibits excellent efficacy but also high safety.
Keywords
Submucosal injection solution; Sodium hyaluronate; Therapeutic efficacy
Funding
The Youth Cultivation Fund Project in The First Affiliated Hospital of Hainan Medical University in 2020 (Project Number: HYYFYPY202019)
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[2]Lee IL, Lin PY, Tung SY, Shen CH, Wei KL, Wu CS. Endoscopic submucosal dissection for the treatment of intraluminal gastric subepithelial tumors originating from the muscularis propria layer. Endoscopy 2006; 38: 1024-1028.
[3]Lu J, Jiao T, Zheng M, Lu X. Endoscopic resection of submucosal tumors in muscularis propria: the choice between direct excavation and tunneling resection. Surg Endosc 2014; 28: 3401-3407.
[4]Zhou DJ, Dai ZB, Wells MM, Yu DL, Zhang J, Zhang L. Submucosal tunneling and endoscopic resection of submucosal tumors at the esophagogastric junction. World J Gastroenterol 2015; 21: 578-583.
[5]Duan TY, Tan YY, Wang XH, Lv L, Liu DL. A comparison of submucosal tunneling endoscopic resection and endoscopic full-thickness resection for gastric fundus submucosal tumors. Rev Esp Enferm Dig 2018; 110: 160-165.
[6]Yuan Yuan, Zhang Deqing, Li Rui, et al. Application of sodium hyaluronate in endoscopic submucosal dissection. Chinese Journal of Digestive Endoscopy, 2018, 35 (1): 45-48.
[7]Mao XL, Ye LP, Zheng HH, Zhou XB, Zhu LH, Zhang Y. Submucosal tunneling endoscopic resection using methylene-blue guidance for cardial subepithelial tumors originating from the muscularis propria layer. Dis Esophagus 2017; 30: 1-7.
[8]Zhou DJ, Dai ZB, Wells MM, Yu DL, Zhang J, Zhang L. Submucosal tunneling and endoscopic resection of submucosal tumors at the esophagogastric junction. World J Gastroenterol 2015; 21: 578-583.
[9]Du C, Ma L, Chai N, Gao Y, Niu X, Zhai Y, Li Z, Meng J, Tang P, Linghu E. Factors affecting the effectiveness and safety of submucosal tunneling endoscopic resection for esophageal submucosal tumors originating from the muscularis propria layer. Surg Endosc 2018; 32: 1255- 1264.
[10]Meyer K,The biological significance of hyaluronic acid and hyaluronidase.Physiol Rev,1947,27:335-359.
[11]Ling Peixue. Research and application of hyaluronic acid [M]. Beijing: People's Health Publishing House, 2010.
[12]Zhang Hongkui, Wang Shaochen, Wang Yongti, et al. Intra-articular injection of sodium hyaluronate for the treatment of knee osteoarthritis [J]. Chinese Journal of Biochemical Medicine, 1998, 19:231-234.
Copyright © 2023 Anfu Zhou, Yan Tan, Yangqing Jiang, Yan Wang, Jing Tang
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