Background and Aims
The safety and efficacy of submucosal injection solutions are critical for endoscopic resection of gastric adenomas or early gastric cancers. Although several submucosal injection solutions have been introduced for endoscopic resection, they have limitations. We aimed to compare the efficacy of the new sodium alginate-based solution MC-003 with 0.9% normal saline (NS).
Methods
In this randomized triple-blind study, 70 patients were initially enrolled for endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The main outcomes included need for additional injections, completion of en bloc resection, and occurrence of adverse events.
Results
Each group finally comprised 34 patients. Complete en bloc resections were achieved in all patients (P = 1.000). The MC-003 group had more peri-neoplasm tissue fibrosis (P = 0.056) and needed fewer additional injections for lesions larger than 15 mm (P = 0.037), located in the distal part (P = 0.007) and during ESD procedures (P = 0.001), whereas the adverse event rate was comparable in both groups.

Conclusions
MC-003 demonstrated usefulness superior to that of NS in reducing the need for additional injections during en bloc resection, particularly in larger lesions located in the distal part (where most lesions were found) during ESD procedures, without increasing the incidence of serious adverse events. MC-003 is a promising submucosal injection solution in real-world clinical settings.

Seong Hwan Kim

Appearances