3465 The durability of different solutions injected submucosally in a porcine model.

During endoscopic mucosal resection and polypectomy of sessile lesions an injected submucosal fluid cushion isolates the tissue prior to resection and reduces thermal injury, perforation, and hemorrhage. Aim: To investigate the efficacy of five different solutions in creating a durable submucosal esophageal fluid cushion in a pig model. Methods: Five groups of 5 pigs were studied. In each pig, six submucosal injections of 5 cc of a test solution were performed within the lower third of the esophagus. The time required for the elevated mucosa to flatten completely was recorded after each injection. The solutions used were: normal saline (NS), NS+epinephrine (NSE), dextrose 50% (D50), 10% glycerine/5% fructose in NS (G), and 1% rooster comb hyaluronic acid (HA). Statistical analysis was performed using analysis of variance (ANOVA). NS was used as the standard solution for comparative analysis. Results: The mean and median times (minutes) for each solution to dissipate are provided in the table below. Conclusions: 1. This study provides important and practical information on the durability of available solutions used to create a submucosal fluid cushion during endoscopic mucosal resection and polyectomy of sessile lesions. 2. Hyaluronic acid appears to be the ideal solution for a lasting submucosal cushion during prolonged procedures. 3. Dextrose 50% is superior to normal saline and serves as a practical alternative in terms of availabilty and cost.