The Experimental Study of Physiological Change in the Submucosal Layers after the Saline Injection / 대한소화기내시경학회지

ABSTRACT

BACKGROUND/AIMS: In EMR, submucosal saline injection is used in order to prevent perforation and hemorrhage, but it is not well known on the physiological change of submucosal layer by injected saline. This study was undertaken to assess experimentally the physiological change of submucosal layer after the saline injection on mongrel's surgical specimens. METHODS: Twenty one fresh specimens were obtained from esophagus, stomach and colon for 3 mongrels' experiments. Saline was injected from 1 mL to 20 mL into submucosa of all specimens on which target areas were made by electrocautery markings. By gross morphology of the elevated area and endoscopic sonographic image and by histological features on submucosa of each specimen, mucosal extension was measured after saline injection. RESULTS: The height of blebs and minimal diameters of target areas made increased up to a fixed dose, but did not increased after that. However, the maximal and minimal diameters of elevated areas and the difference between these diameters increased proportional to the volume of injected saline. Moreover, retained salines were interspersed evenly among the connective tissues in submucosa despite of the increasing dose of injected saline. CONCLUSION: Morphological change in submucosa is not changed proportional to the volume of injected saline.