submucosal injection
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Abstract When applying the improved composition of the solution used during endoscopic mucosal resection (EMR), we observed unexpectedly large and quantitatively significant differences in adenoma response vs. healthy tissue of the surrounding GIT tract, namely, the selective reaction enhancing the adenoma volume and differentiated colour. The in vitro experiments on the model neoplasia cell line HCT116 suggest that the robust differences in the response of starving cells can be traced down principally to tetrastarch digestion and the enhanced metabolic rate of neoplastic cells. The neoplastic tissue grows into several intestine layers so that submucosal injection of iso-oncotic tetrastarch compound leads to degradation of starch and production of oncotic molecules in submucosa transported by facilitated transport into the neoplastic tissue. The colour distinction is due to concentration differences of the reporting dye between three separated compartments, further enhancing the utility of the contrasting mixture. The diffusion dynamics shall be tuneable by optimizing starch composition, improving desirable pharmacokinetics.

Abstract When applying the improved composition of the solution used during endoscopic mucosal resection (EMR), we observed unexpectedly large and quantitatively significant differences in adenoma response vs. healthy tissue of the surrounding GIT tract, namely, the selective reaction enhancing the adenoma volume and differentiated colour. The in vitro experiments on the model neoplasia cell line HCT116 suggest that the robust differences in the response of starving cells can be traced down principally to tetrastarch digestion and the enhanced metabolic rate of neoplastic cells. The neoplastic tissue grows into several intestine layers so that submucosal injection of iso-oncotic tetrastarch compound leads to degradation of starch and production of oncotic molecules in submucosa transported by facilitated transport into the neoplastic tissue. The colour distinction is due to concentration differences of the reporting dye between three separated compartments, further enhancing the utility of the contrasting mixture. The diffusion dynamics shall be tuneable by optimizing starch composition, improving desirable pharmacokinetics.

Objective. To improve the results of diagnosis and surgical treatment of rectal mucosa prolapse, complicated by the anal sphincter insufficiency. Materials and methods. Analysis of the diagnosis and surgical treatment results in the rectal mucosa prolapse with the anal sphincter insufficiency was done in 23 patients, ageing 31 - 65 yrs old and the age median (41.5 ± 1.8) yrs old, of them 17 women-patients. Results. There was revealed, that most frequently and in mostly progressive forms the rectal mucosa prolapse with the anal sphincter insufficiency occurs in women, aged more than 36 yrs old. Conclusion. Miniinvasive transanal operations, submucosal injection procedures and sphincteroplasty “end-to-end” were used predominantly, owing less morbidity potency (26.1%), favorable remote functional results - the recurrence rate lowering (4.3%), the fecal incontinence degree lowering (78.6%), and the patients’ quality of life improvement.

Abstract Background and study aim Cold resection is becoming the standard of care for the resection of nonpedunculated colon lesions up to 10 mm in diameter. Sessile serrated adenomas/polyps (SSA/Ps), including those ≥ 10 mm, present various characteristics that make them ideal candidates for cold snare polypectomy (CSP). Patients and methods A prospectively maintained database was searched retrospectively for consecutive patients with lesions ≥ 10 mm resected between March 2013 and March 2018. During that period, all SSA/P-appearing lesions were resected using CSP without submucosal injection, except for lesions with endoscopic suspicion of dysplasia or submucosal invasion. Patients with a pathological diagnosis of SSA/P were included in the analysis. Adverse events were recorded up to 21 days following colonoscopy. Results 615 SSA/Ps ≥ 10 mm were resected during 452 colonoscopy procedures in 379 patients (mean age 54.1 years; standard deviation [SD] 11.9 years). Mean polyp size was 13.7 (SD 5.2) mm; 122 lesions (19.8 %) were ≥ 20 mm and 479 lesions (77.9 %) underwent piecemeal resection. Immediate adverse events included persistent abdominal pain that resolved spontaneously within 2 hours in three patients (0.8 %; 95 % confidence interval [CI] 0.2 %–2.3 %). One patient with persistent intraprocedural bleeding was successfully treated with a hemostatic clip. No late adverse events were detected. Surveillance colonoscopy was performed in 293 patients (77.3 %) at 23.4 (SD 11.6) months following index colonoscopy; residual/recurrent lesions were diagnosed in 23 patients (7.8 %; 95 %CI 5.0 %–11.6 %). Conclusion CSP without submucosal injection appeared to be safe and effective for the resection of large SSA/Ps.

Abstract When applying the improved composition of solution used during endoscopic mucosal resection (EMR), we have observed unexpectedly large and quantitatively significant differences in adenoma response vs. healthy tissue of surrounding GIT tract, namely the selective reaction enhancing the adenoma volume and differentiated colour. The in vitro experiments on model neoplasia cell line HCT116 suggest that the robust differences in the response of starving cells can be traced down principally to the tetrastarch digestion and enhanced metabolic rate of neoplastic cells. The neoplastic tissue grows into several intestine layers so that submucosal injection of iso-oncotic tetrastarch compound leads to degradation of starch and production of oncotic molecules in submucosa transported by facilitated transport into the neoplastic tissue. The colour distinction is due to concentration differences of the reporting dye between three separated compartments, further enhancing the utility of the contrasting mixture. The diffusion dynamics shall be tuneable by optimizing starch composition, improving desirable pharmacokinetics.

Abstract When applying improved composition of solution used during endoscopic mucosal resection (EMR), we have observed unexpectedly large and quantitatively significant difference in response of adenoma vs. healthy tissue of surrounding GIT tract, namely the selective reaction enhancing the volume and differentiated colour. The in vitro experiments on model neoplasia cell line HCT116 suggest, that the robust differences in response of starving cells can be traced down principally to the tetrastarch digestion of neoplastic tissue and enhanced metabolic rate of neoplastic cells. The neoplastic tissue grows into several intestine layers so that submucosal injection of iso-oncotic tetrastarch compound leads to degradation of starch and production of oncotic molecules in submucosa transported by facilitated transport into neoplastic tissue. The colour distinction of the reporting dye is due to concentration differences of three separated compartments, further enhancing the utility of the contrasting mixture. The diffusion dynamics shall be tuneable by optimizing starch composition improving desirable pharmacokinetics.