A0426 - Optimal Submucosal Injection for Submucosal Dissection: A Single-Center Experience

Sera Satoi, MD, Makoto Nishimura, MD, Kana Chin, MD, Jacques C. Beauvais, MD, Mark Schattner, MD
Memorial Sloan Kettering Cancer Center, New York, NY

Introduction: A submucosal injection is an essential technique for endoscopic submucosal dissection (ESD) to lift the lesion. Not only does this facilitate en-bloc resection, but it also provides sufficient submucosa for proper pathologic evaluation of margin and lymphovascular invasion. Several injection agents for ESD have been developed, including ORISE Gel (Boston Scientific, MA, USA) and Eleview (Aries Pharmaceutical, CA, USA), however, few studies have examined the clinical outcomes of each lifting agent. Here we compared the clinical outcomes of ORISE Gel and Eleview used during the ESD of colorectal lesions.

Methods: A total of 90 patients who underwent ESD were included in this retrospective cohort study. 2mm Dual-J Knife (Olympus) or 1.5mm ProKnife (Boston Scientifics) were used for resection. Patients were divided into a comparison group: ORISE group (n=36) vs Eleview group (n=54). The primary outcome was the amount of each agent used to achieve adequate submucosal lifting. Secondary outcomes were en-bloc resection rate, R0 resection rates, ESD time, length of hospital stay, and adverse events. R0 resection was defined as an en-bloc resection with microscopically negative margins. The two groups were compared using the Independent t-tests and chi-square tests.

Results: The ORISE group had a significantly lower amount of agent used (30 mL vs 65.5 ml, p< 0.001) and shorter procedure time (90.0 min vs 120.0 min, p=0.05) when compared with the Eleview group, while there was no difference in en-bloc resection rate (77.8% vs 70.4%, p=0.48), R0 resection rate (61.1% vs 59.3%, p=0.83) hospital length of stay (1.03±0.70 vs 1.39±2.41, p=0.39), or adverse events (16.7% vs 11.1%, p=0.53).

Discussion: The use of ORISE for colorectal ESD was significantly associated with a lower amount of gel used for submucosal lifting and shorter procedure time while there were no differences in the en-bloc resection or R0 resection rates, hospital length of stays, and adverse events compared to Eleview. Further study is warranted to investigate the clinical outcomes of different lifting agents used for ESD.



Disclosures:


Sera Satoi, MD, Makoto Nishimura, MD, Kana Chin, MD, Jacques C. Beauvais, MD, Mark Schattner, MD. A0426 - Optimal Submucosal Injection for Submucosal Dissection: A Single-Center Experience, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.