Chemically assisted endoscopic mechanical submucosal dissection by using mesna

Kazuki Sumiyama, Christopher J. Gostout, Elizabeth Rajan, Timothy A. Bakken, Mary A. Knipschield

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: A class of thiol compounds, mesna (sodium-2-mercaptoethanesulfonate), has been used to facilitate tissue dissection in surgical fields. Objectives: To evaluate the technical feasibility and efficacy of chemically assisted endoscopic mechanical submucosal dissection (CAEMSD) by using mesna. Design: An in vivo controlled blind trial by using porcine models. Settings: Nonsurvival study in an animal laboratory. Interventions: Six pigs were studied. Mucosal targets of about 2 cm (estimated) for treatment were created with a circle of cauterized spots along the greater curvature of the gastric body and the antrum. A mesna solution or the control hydroxypropyl methylcellulose solution was submucosally injected. The target mucosa was mechanically isolated with balloon dissection and removed by circumferential incision with a hook-knife inserted into the submucosal space. Necropsy and mucosal specimens from both groups were examined by histology. Results: En bloc resection of the target was achieved in all 8 attempts of the mesna group and in 7 of 8 attempts of the control group. Use of mesna significantly reduced tissue resistance to the initial balloon-catheter insertion into the submucosa and the technical difficulty of subsequent submucosal balloon dissection by using a subjective grading system (P < .05). There was no difference in histology between both groups. Conclusions: CAEMSD is a unique methodology to facilitate mucosal resection.

Original languageEnglish (US)
Pages (from-to)534-538
Number of pages5
JournalGastrointestinal Endoscopy
Volume67
Issue number3
DOIs
StatePublished - Mar 2008

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Mesna
Dissection
Histology
Swine
Pyloric Antrum
Laboratory Animals
Sulfhydryl Compounds
Mucous Membrane
Catheters
Endoscopic Mucosal Resection
Control Groups

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Sumiyama, K., Gostout, C. J., Rajan, E., Bakken, T. A., & Knipschield, M. A. (2008). Chemically assisted endoscopic mechanical submucosal dissection by using mesna. Gastrointestinal Endoscopy, 67(3), 534-538. https://doi.org/10.1016/j.gie.2007.10.041

Chemically assisted endoscopic mechanical submucosal dissection by using mesna. / Sumiyama, Kazuki; Gostout, Christopher J.; Rajan, Elizabeth; Bakken, Timothy A.; Knipschield, Mary A.

In: Gastrointestinal Endoscopy, Vol. 67, No. 3, 03.2008, p. 534-538.

Research output: Contribution to journalArticle

Sumiyama, K, Gostout, CJ, Rajan, E, Bakken, TA & Knipschield, MA 2008, 'Chemically assisted endoscopic mechanical submucosal dissection by using mesna', Gastrointestinal Endoscopy, vol. 67, no. 3, pp. 534-538. https://doi.org/10.1016/j.gie.2007.10.041
Sumiyama, Kazuki ; Gostout, Christopher J. ; Rajan, Elizabeth ; Bakken, Timothy A. ; Knipschield, Mary A. / Chemically assisted endoscopic mechanical submucosal dissection by using mesna. In: Gastrointestinal Endoscopy. 2008 ; Vol. 67, No. 3. pp. 534-538.
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