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Endosc Int Open 2014; 02(03): E193-E195
DOI: 10.1055/s-0034-1377444
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© Georg Thieme Verlag KG Stuttgart · New York

Polyethylene glycol submucosal irrigation: a novel approach to improve visibility during endoscopic submucosal dissection

Vitor Arantes
1   Faculdade de Medicina da Universidade Federal de Minas Gerais - Alfa Institute of Gastroenterology, Belo Horizonte, Brazill
,
Takashi Toyonaga
2   Kobe University Hospital – Endoscopy, Kobe, Japan
,
Elias Alfonso Forero Piñeros
3   Hospital de la Policia – Endoscopy, Bogota, Colombia
› Author Affiliations
Further Information

Publication History

submitted 21 April 2014

accepted 03 June 2014

Publication Date:
16 July 2014 (online)

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Endoscopy International Open – recently publishedEndoscopy 2014; 46(09): 818-818
DOI: 10.1055/s-0034-1389704

In order to expand the availability of endoscopic submucosal dissection (ESD), measures to facilitate the procedure are necessary. When bleeding occurs, the examiner’s field of vision is critically impaired, and ESD becomes less efficient and more hazardous because of the presence of submucosal hematoma and covered blood clot. We propose the use of polyethylene glycol (PEG) irrigation as a simple and effective measure to improve visibility during submucosal dissection, particularly when bleeding occurs. PEG irrigation facilitates further dissection by allowing a better recognition of the submucosal fibers and muscularis propria layer.

 

  • References

  • 1 Toyonaga T, Nishino E, Hirooka T et al. Use of short needle knife for esophageal endoscopic submucosal dissection. Dig Endosc 2005; 17: 246-252
    CrossrefPubMedGoogle Scholar
  • 2 Toyonaga T, Man-I M, Fujita T et al. The performance of a novel ball-tipped Flush knife for endoscopic submucosal dissection: a case-control study. Aliment Pharmacol Ther 2010; 32: 908-915
    CrossrefPubMedGoogle Scholar
  • 3 Uraoka T, Saito Y, Yahagi N. What are the latest developments in colorectal endoscopic submucosal dissection?. World J Gastrointest Endosc 2012; 4: 296-300
    CrossrefPubMedGoogle Scholar
  • 4 Park CH, Lee SK. Preventing and controlling bleeding in gastric endoscopic submucosal dissection. Clin Endosc 2013; 46: 456-462
    CrossrefPubMedGoogle Scholar
  • 5 Yoshida N, Yagi N, Nayto Y et al. Safe procedure in endoscopic submucosal dissection for colorectal tumors focused on preventing complications. World J Gastroenterol 2010; 16: 1688-1695
    CrossrefPubMedGoogle Scholar
  • 6 Toyonaga T, Nishino E, Hirooka T et al. Intraoperative bleeding in endoscopic submucosal dissection in the stomach and strategy for prevention and treatment. Dig Endosc 2006; 18: 123-127
    CrossrefPubMedGoogle Scholar
  • 7 Toyonaga T, Nishino E, Dozaiku T et al. Management to prevent bleeding during endoscopic submucosal dissection using the flush knife for gastric tumors. Dig Endosc 2007; 19: 14-18
    CrossrefPubMedGoogle Scholar
  • 8 Ishihara H. Current status and prospects of polyethyleneglycol-modified medicines. Biol Pharm Bull 2013; 36: 883-888
    CrossrefPubMedGoogle Scholar
  • 9 Polymeros D, Kotsalidis G, Triantafyllou K et al. Comparative performance of novel solutions for submucosal injection in porcine stomachs: an ex vivo study. Dig Liver Dis 2010; 42: 226-229
    CrossrefPubMedGoogle Scholar