Value of absorbable hemostat textile as submucosal injection of endoscopic submucosal dissection

Abstract

Objective To evaluate the application value of absorbable hemostat textile as submucosal injection of endoscopic submucosal dissection (ESD). Methods Twelve New Zealand rabbits were injected with absorbable hemostat textile solution, glycerol fructose and normal saline. The uplift effect was measured after injection. Simulated ESD was performed in the rabbit stomach and bleeding amount was measured. The injection site was pathologically examined at 30 minutes after the soluble hemostat textile and normal saline were injected. Fifteen pigs were injected with absorbable hemostat textile at two locations of 20-30 cm from the anus, and injected normal saline at another two locations of 20-30 cm from the anus. One site was performed simulated ESD and the other was not. Fifteen simulated ESD were performed in the soluble hemostatic group and the normal saline group, respectively. Operation time was recorded and difference in wound healing was compared between the two groups. Results In the uplift experiment, the absorbable hemostat textile group had higher uplift height (4.3±1.4 mm, 4.1±1.9 mm, 3.8±0.7 mm, 3.3±0.9 mm, respectively) at 0 min, 10 min, 20 min, 30 min than that of the glycerol fructose group (4.3±2.2 mm, 4.1±2.0 mm, 3.6±1.4 mm, 3.2±0.8 mm, respectively, P 0.05). In the bleeding experiment, the bleeding amount of absorbable hemostat textile group was significantly less than that of the glycerol fructose group (0.36±0.07 mL VS 0.42±0.06 mL, P<0.05); the bleeding amount of glycerol fructose group was significantly lower than that of the normal saline group (0.42±0.06 mL VS 0.55±0.07 mL, P<0.05). There was no obvious tissue necrosis and other adverse complications in the absorbable hemostat textile group and the normal saline group. In simulated ESD experiment, complete resection rate of the absorbable hemostat textile group was higher than that of the normal saline group [86.7%(13/15) VS 46.7%(7/15), P<0.05], and mean operation time of the absorbable hemostat textile group was less than that of the normal saline group (3.2±0.3 min VS 3.8±0.5 min, P<0.05). No hemorrhage, perforations or other related adverse events occurred in non-ESD lesions. Conclusion Absorbable hemostat textile is safe and effective as submucosal injection of ESD. Key words: Models, animal; Endoscopic submucosal dissection; Absorbable hemostat textile; Wound repair; Submucosal fluid cushion