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Development of Sodium Polyacrylate-Based High-Performance Submucosal Injection Material with Pseudoplastic Fluid Characteristics
journal contribution
posted on 2019-11-26, 15:38 authored by Ryohei Hirose, Naohisa Yoshida, Yuji Naito, Takuma Yoshida, Risa Bandou, Tomo Daidoji, Ken Inoue, Osamu Dohi, Hideyuki Konishi, Takaaki Nakaya, Yoshito ItohThe development of high-performance submucosal injection
materials
(SIMs) has significantly contributed to the advancement of rapid and
safe endoscopic submucosal dissection (ESD). A previous study authored
by us described that pseudoplastic fluid was more suitable for high-performance
SIMs than Newtonian fluid. Herein, a novel high-performance SIM is
developed, which is primarily composed of sodium polyacrylate (SPA)
and exhibits pseudoplastic fluid characteristics. As a representative
of current high-performance SIMs with Newtonian fluid characteristics,
0.4% sodium hyaluronate (HA) was selected as the target for comparison.
Further, viscoelasticity, submucosal elevation height (SEH), and injection
pressure (IP) of HA and SPA were evaluated. The results obtained by
ESD were compared using HA or SPA in an ex vivo model. According to
the measured viscoelasticity, the concentration of SPA was adjusted
to 0.07%; this was aimed at obtaining the IP of SPA, which is equal
to that of 0.4% HA. Moreover, no significant difference was observed
between the IP values (31.6 ± 1.7 vs 31.4 ± 3.1 psi). SEHs
of 0.07% SPA were higher than those of 0.4% HA at all postinjection
times (P < 0.001). The duration of the ESD procedure
using 0.07% SPA was significantly shorter than that obtained using
0.4% HA (16.6 ± 3.7 vs 22.2 ± 2.9 min, P = 0.0276); further, the total volume of the injected 0.07% SPA was
significantly less than that of 0.4% HA (9.0 ± 3.1 vs 15.7 ±
3.9 mL, P = 0.0165). Based on rheological analysis,
a high-performance SIM (0.07% SPA) with pseudoplastic fluid characteristics
was theoretically developed. It was observed that the SIM performance
of 0.07% SPA was higher than that of 0.4% HA.
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Pseudoplastic Fluid CharacteristicsSPAendoscopic submucosal dissectioninjection pressureexhibits pseudoplastic fluid characteristicsHAsubmucosal injection materialsNewtonian fluidpseudoplastic fluidSodium Polyacrylate-Based High-Performance Submucosal Injection Materialvivo modelSEHsubmucosal elevation heightSIM performancepostinjection timesESD procedureIPrheological analysissodium polyacrylateNewtonian fluid characteristicspseudoplastic fluid characteristics
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