| A comparative study of 50% dextrose and normal saline solution on their ability to create submucosal fluid cushions for endoscopic resection of sessile rectosigmoid polyps. | |
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MedLine Citation:
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PMID: 18514651 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: EMR traditionally performed by using normal saline solution (NS) plus epinephrine (E) as a submucosal fluid cushion does not maintain the submucosal elevation for a prolonged time. It was hypothesized that 50% dextrose (D(50)) plus E as a hypertonic, inexpensive, and easily available solution might be an ideal alternative for producing and maintaining more-prolonged mucosal elevation. OBJECTIVE: To evaluate D(50)+E versus NS+E during an EMR of sessile rectosigmoid polyps (> 10 mm). DESIGN: A prospective, double-blind, randomized study that compared EMR by using either D(50)+E or NS+E submucosal fluid cushions. SETTING: Four tertiary endoscopic referral centers with 1370 polypectomies in 2006, performed by 5 experienced endoscopists. PATIENTS: Patients treated for sessile rectosigmoid polyps (> 10 mm). INTERVENTIONS: Polypectomy with D(50)+E or NS+E submucosal fluid cushions. MAIN OUTCOME MEASUREMENTS: The duration of submucosal elevation, volume of solution, number of required injections to maintain the elevation, and observations for complications. RESULTS: Ninety-two sessile rectosigmoid polyps were removed. Injected solution volumes and the number of injections to maintain submucosal elevation were lower in the D(50)+E group than in the NS+E group (P = .033 and P = .028, respectively). Submucosal elevation had a longer duration in the D(50)+E group (P = .043). This difference mainly included large (> or = 20 mm) and giant (> 40 mm) polyps. There were 6 and 1 cases of postpolypectomy syndrome in the D(50)+E and NS+E groups, respectively (P = .01). LIMITATIONS: May be limited by inexperienced endoscopist's lack of injection and polypectomy skills. CONCLUSIONS: D(50)+E is superior to NS+E for an EMR, particularly in large and giant sessile polyps, but the risk of thermal tissue injury should be considered. |
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Authors:
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Panagiotis Katsinelos; Jannis Kountouras; George Paroutoglou; Grigoris Chatzimavroudis; Christos Zavos; Ioannis Pilpilidis; George Gelas; Dimitris Paikos; Konstantinos Karakousis |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2008-06-02 |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 68 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-17 Completed Date: 2009-02-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 692-8 Citation Subset: IM |
Affiliation:
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Department of Endoscopy and Motility Unit, G. Gennimatas General Hospital, Thesaloniki, Greece. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Colonic Polyps / pathology, surgery* Double-Blind Method Endoscopy, Gastrointestinal / methods* Female Glucose* Humans Intestinal Mucosa / physiology Intestinal Polyps / pathology, surgery* Male Middle Aged Prospective Studies Rectal Diseases / pathology, surgery* Sigmoid Diseases / pathology, surgery* Sodium Chloride* Solutions Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Solutions; 50-99-7/Glucose; 7647-14-5/Sodium Chloride |
| Comments/Corrections | |
Comment In:
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Gastrointest Endosc. 2008 Oct;68(4):699-700
[PMID:
18926178
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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