Evaluation of 0.6% sodium alginate as a submucosal injection material in endoscopic submucosal dissection for early gastric cancer

Dig Endosc. 2014 Sep;26(5):638-45. doi: 10.1111/den.12268. Epub 2014 Mar 24.

Abstract

Background and aim: We have focused on sodium alginate (SA) solution as a potential submucosal injection material for endoscopic submucosal dissection (ESD). A previous SA solution had high viscosity and problems such as difficult handling. After its properties were adjusted, SA solution was examined in vitro and its clinical safety was evaluated.

Methods: With 0.4% sodium hyaluronate (SH) solution as a control, catheter injectability and mucosa-elevating capacity of 0.3-0.8% SA solutions were evaluated. Next, 0.6% SA solution was used for ESD in 10 patients with early gastric cancer in a prospective clinical study.

Results: Compared with 0.4% SH solution, 0.6% SA solution exhibited no significant difference in catheter injectability but significant superiority in mucosa-elevating capacity. In the clinical study, no adverse events were observed in any patient.

Conclusion: The safety of 0.6% SA solution as a submucosal injection material was confirmed and it is suggested that its efficacy should be investigated in a larger number of cases.

Keywords: early gastric cancer; endoscopic submucosal dissection; endoscopic submucosal injection material; feasibility study; sodium alginate.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Alginates / administration & dosage*
  • Animals
  • Biocompatible Materials / administration & dosage
  • Dissection / methods*
  • Drug Carriers
  • Early Detection of Cancer
  • Female
  • Gastric Mucosa / pathology
  • Gastric Mucosa / surgery*
  • Gastroscopy / methods*
  • Glucuronic Acid / administration & dosage
  • Hexuronic Acids / administration & dosage
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Neoplasms, Experimental
  • Prospective Studies
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / surgery*
  • Swine
  • Treatment Outcome

Substances

  • Alginates
  • Biocompatible Materials
  • Drug Carriers
  • Hexuronic Acids
  • Glucuronic Acid