Arnaldo B. Feitoza, MD, Christopher J. Gostout, MD, Lawrence J

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Presentation transcript:

Hydroxypropyl methylcellulose: A better submucosal fluid cushion for endoscopic mucosal resection Arnaldo B. Feitoza, MD, Christopher J. Gostout, MD, Lawrence J. Burgart, MD, Alexander Burkert, MD, Lori J. Herman, LPN, CGN, Elizabeth Rajan, MD Gastrointestinal Endoscopy Volume 57, Issue 1, Pages 41-47 (January 2003) DOI: 10.1067/mge.2003.25 Copyright © 2003 American Society for Gastrointestinal Endoscopy Terms and Conditions

Fig. 1 Endoscopic views of submucosal fluid cushion (SFC) created by injection of hydroxypropyl methylcellulose in esophagus of pigs. A, Injection into submucosa. B, Injection completed, beginning time recording. C, SFC after 22 minutes. D, SFC after 45 minutes. Gastrointestinal Endoscopy 2003 57, 41-47DOI: (10.1067/mge.2003.25) Copyright © 2003 American Society for Gastrointestinal Endoscopy Terms and Conditions

Fig. 2 Endoscopic appearance at 1 week after creation of submucosal fluid cushion sites with hydroxypropyl methylcellulose. A, Normal-appearing mucosa with disappearance of SFC at site of hydroxypropyl methylcellulose injection. B, Stained ulcerated nodule at tattoo site. Gastrointestinal Endoscopy 2003 57, 41-47DOI: (10.1067/mge.2003.25) Copyright © 2003 American Society for Gastrointestinal Endoscopy Terms and Conditions

Fig. 3 Photomicrographs of histologic sections made 1 week after submucosal fluid cushion (SFC) sites created by submucosal injection of hydroxypropyl methylcellulose. A, SFC lifting mucosa (H&E, orig. mag. ×100). B, Foamy macrophages (FM) in submucosa (SM) (H&E, orig. mag. ×100). C, Localized fibrinoid necrosis and vasculitis (arrows) found in 2 sites in single animal that had pulmonary infection after the procedure; muscularis propria (MP) is preserved (H&E, orig. mag. ×100). D, Tattoo dye surrounded by inflammatory cells and residual hydroxypropyl methylcellulose (HPMC) in submucosa; mucosa is preserved (H&E, orig. mag. ×100). Gastrointestinal Endoscopy 2003 57, 41-47DOI: (10.1067/mge.2003.25) Copyright © 2003 American Society for Gastrointestinal Endoscopy Terms and Conditions