BACKGROUND: Biodegradable hydrogels can deliver therapeutic payloads with great potentials in EMR and endoscopic submucosal dissection (ESD) to yield improvements in efficacy and foster mucosal regeneration. OBJECTIVE: To assess the efficacy of an injectable drug-eluting elastomeric polymer (iDEEP) as a submucosal injection material. DESIGN: Comparative study of 3 different solutions by using material characterization tests and ex vivo and in vivo porcine models. SETTING: Academic hospital. INTERVENTIONS: Thirty gastric submucosal cushions were achieved with saline solution (0.9%), sodium hyaluronate (0.4%), and iDEEP (n = 10) in ex vivo porcine stomachs. Four porcine gastric submucosal cushions were then created in vivo by using iDEEP. MAIN OUTCOME MEASUREMENTS: Maximum injection pressure, rebamipide release rate, submucosal elevation duration, and assessment of in vivo efficacy by en bloc resection. RESULTS: No significant difference in injection pressures between iDEEP (28.9 ± 0.3 psi) and sodium hyaluronate (29.5 ± 0.4 psi, P > .05) was observed. iDEEP gels displayed a controlled release of rebamipide up to 2 weeks in vitro. The elevation height of iDEEP (5.7 ± 0.5 mm) was higher than that of saline solution (2.8 ± 0.2 mm, P < .01) and sodium hyaluronate (4.2 ± 0.2 mm, P < .05). All EMR procedures were successfully performed after injection of iDEEP, and a large gel cushion was noted after the resection procedure. LIMITATIONS: Benchtop, ex vivo, and nonsurvival pig study. CONCLUSIONS: A novel injection solution was evaluated for endoscopic resection. These results suggest that iDEEP may provide a significant step toward the realization of an ideal EMR and endoscopic submucosal dissection injection material.
BACKGROUND: Biodegradable hydrogels can deliver therapeutic payloads with great potentials in EMR and endoscopic submucosal dissection (ESD) to yield improvements in efficacy and foster mucosal regeneration. OBJECTIVE: To assess the efficacy of an injectable drug-eluting elastomeric polymer (iDEEP) as a submucosal injection material. DESIGN: Comparative study of 3 different solutions by using material characterization tests and ex vivo and in vivo porcine models. SETTING: Academic hospital. INTERVENTIONS: Thirty gastric submucosal cushions were achieved with saline solution (0.9%), sodium hyaluronate (0.4%), and iDEEP (n = 10) in ex vivo porcine stomachs. Four porcine gastric submucosal cushions were then created in vivo by using iDEEP. MAIN OUTCOME MEASUREMENTS: Maximum injection pressure, rebamipide release rate, submucosal elevation duration, and assessment of in vivo efficacy by en bloc resection. RESULTS: No significant difference in injection pressures between iDEEP (28.9 ± 0.3 psi) and sodium hyaluronate (29.5 ± 0.4 psi, P > .05) was observed. iDEEP gels displayed a controlled release of rebamipide up to 2 weeks in vitro. The elevation height of iDEEP (5.7 ± 0.5 mm) was higher than that of saline solution (2.8 ± 0.2 mm, P < .01) and sodium hyaluronate (4.2 ± 0.2 mm, P < .05). All EMR procedures were successfully performed after injection of iDEEP, and a large gel cushion was noted after the resection procedure. LIMITATIONS: Benchtop, ex vivo, and nonsurvival pig study. CONCLUSIONS: A novel injection solution was evaluated for endoscopic resection. These results suggest that iDEEP may provide a significant step toward the realization of an ideal EMR and endoscopic submucosal dissection injection material.
Authors: Sergey V Kantsevoy; Douglas G Adler; Jason D Conway; David L Diehl; Francis A Farraye; Richard Kwon; Petar Mamula; Sarah Rodriguez; Raj J Shah; Louis Michel Wong Kee Song; William M Tierney Journal: Gastrointest Endosc Date: 2008-07 Impact factor: 9.427
Authors: Dimitrios Polymeros; George Kotsalidis; Konstantinos Triantafyllou; George Karamanolis; John G Panagiotides; Spiros D Ladas Journal: Dig Liver Dis Date: 2009-07-09 Impact factor: 4.088
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Authors: Xinyu Tan; Ethan Gerhard; Yuqi Wang; Richard T Tran; Hui Xu; Su Yan; Elias B Rizk; April D Armstrong; Yuxiao Zhou; Jing Du; Xiaochun Bai; Jian Yang Journal: Small Date: 2022-06-19 Impact factor: 15.153