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Endoscopy 2008; 40(2): 110-114
DOI: 10.1055/s-2007-966987
Original article

© Georg Thieme Verlag KG Stuttgart · New York

EMR using dextrose solution versus sodium hyaluronate for colorectal Paris type I and 0-II lesions: a randomized endoscopist-blinded study

D.  P.  Hurlstone1 , K.  I.  Fu2 , S.  R.  Brown1 , M.  Thomson3 , R.  Atkinson1 , N.  Tiffin4 , S.  S.  Cross4
  • 1Gastroenterology and Liver Unit at the Royal Hallamshire Hospital Sheffield, UK
  • 2Department of Radiology, Dokkyo Medical University, Shimotuga, Tochigi, Japan
  • 3Department of Endoscopy, Sheffield Children’s Hospital, Sheffield, UK
  • 4Academic Unit of Pathology, Section of Oncology and Pathology, Division of Genomic Medicine, University of Sheffield Medical School, Sheffield
Further Information

Publication History

submitted 30 March 2007

accepted after revision 27 August 2007

Publication Date:
06 February 2008 (online)

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Commentaire de travail de D. P. Hurlstone et al., pp. 110Endoscopy 2008; 40(02): 233-233
DOI: 10.1055/s-0032-1306805

Background and aims: Loss of mucosal ‘lift’ prior to submucosal dissection or endoscopic mucosal resection (EMR) increases the risk of complications. We conducted a randomized controlled trial comparing dextrose solution with sodium hyaluronic acid (SHA) for the en bloc resection of Paris type I/0-II and lateral spreading lesions of the colorectum.

Patients and methods: Patients with Paris type I/0-II or lateral spreading tumor lesions of < 30 mm were randomized in a 1 : 1 ratio to undergo EMR using either dextrose solution or SHA. The primary study outcome was complete resection. Secondary outcomes were endoscopic complications (i. e. perforation or bleeding) and polyp recurrence rates.

Results: A total of 174 patients were randomized. R0 resection was achieved in 59 of the 82 lesions (72 %) in the dextrose group and 56 of the 81 lesions (69 %) in the SHA group (P > 0.1), with no significant difference in median lesion diameter (P > 0.1). The median number of post resection surveillance colonoscopies was 3 (range 2 - 7) in the dextrose group and 4 (range 2 - 6) in the SHA group (P = NS). The median post index EMR resection follow-up period was 20 months (range 4 - 26) in the DS group and 18 months (range 3 - 22) in the SHA group (P = NS). Recurrence rates were 1/82 (1.21 %) in the dextrose group and 1/81 (1.23 %) in the SHA group (P = NS).

Conclusions: EMR using dextrose solution is as effective as SHA in terms of resection completion, recurrence rates, and complications.

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D. P. Hurlstone, MD

Department of Endoscopy

Room P39/Ward P2

Royal Hallamshire Hospital

Sheffield

S10 2JF

UK

Fax: +44-114-2712692

Email: p.hurlstone@shef.ac.uk

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