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- ItemAcesso aberto (Open Access)Comparative results of gastric submucosal injection with hydroxypropyl methylcellulose, carboxymethylcellulose and normal saline solution in a porcine model(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2010-06-01) Lenz, Luciano [UNIFESP]; Di Sena, Veruska [UNIFESP]; Nakao, Frank S. [UNIFESP]; Andrade, Gustavo Paulo de [UNIFESP]; Rohr, Maria Rachel da Silveira [UNIFESP]; Ferrari, Angelo Paulo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)CONTEXT: Endoscopic mucosal resection is an established modality for excision of sessile lesions in the gastrointestinal tract. Submucosal fluid injection creates a cushion and may prevent thermal injury and perforation. OBJECTIVES: This blind study investigated the performance of three different solutions to create submucosal fluid cushions in porcine stomach. METHODS: Three solutions were injected in the stomach of nine pigs BR1: normal saline solution, carboxymethylcellulose 0.5% and hydroxypropyl methylcellulose 0.25%. In each pig, submucosal injections with 6 mL per test-solution were performed. One drop of methylene blue was added to all injections for better visualization. The time for the bleb to disappear was recorded. RESULTS: The overall median time of visible submucosal cushion was 37 minutes (range 12-60 min) for hydroxypropyl methylcellulose, 31 minutes for carboxymethylcellulose (range 10-43 min) and 19 minutes for normal saline solution (range 8-37 min). There was no statistically significant difference neither between normal saline solution and carboxymethylcellulose (P = 0.146) nor carboxymethylcellulose and hydroxypropyl methylcellulose (P = 0.119) but the median duration of hydroxypropyl methylcellulose was significantly longer than normal saline solution (P = 0.039). CONCLUSIONS: The length of hydroxypropyl methylcellulose submucosal fluid cushion is longer in comparison with normal saline solution. The median time for carboxymethylcellulose was not longer than normal saline solution. Hydroxypropyl methylcellulose, in the concentration of 0.25%, may be a durable alternative for submucosal injection.
- ItemAcesso aberto (Open Access)Diagnóstico e tratamento de tumores carcinóides do trato digestivo(Associação Médica Brasileira, 2002-03-01) Fernandes, Luis CÉsar [UNIFESP]; Pucca, Luiz [UNIFESP]; Matos, Delcio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The authors analyzed the characteristics of carcinoid tumors according to their site in the digestive tract. Despite their low speed of growing and metastasis process, such neoplasias are malignant and must be submitted to surgical resection. Advanced cases with metastases are treated with somatostatin derivatives, lessening symptoms, causing occasional regression of lesions and presenting an extended survival. Appendicular and rectal lesions have a better prognosis maybe due to the early diagnosis performed.