Endoscopic resection with hyaluronate solution for gastrointestinal lesions: systematic review and meta-analysis.

BACKGROUND

A wide range of outcomes are seen in the literature on the use of hyaluronate solution (HS) in endoscopic resection. However, there is little consensus on whether or not HS are beneficial for patients. The purpose of this meta-analysis was to evaluate the usefulness and safety of HS as submucosal fluid cushion for endoscopic resection in patients with gastrointestinal lesions.

METHODS

We searched Pub Med, the Cochrane Library, EMBASE, Science Citation Index Expanded, CMB, VIP, and CNKI for the terms "endoscopic resection" and "hyaluronate solution" used in combination with the medical subject headings. Randomized controlled trials were considered. Meta-analysis was performed by RevMan 5.0 software.

RESULTS

Four randomized control clinical trials (585 patients) were included into the review analyses. There was no significant difference on en bloc resection and complete resection between the 2 groups. The fixed-effect meta-analyses did not favor the use of HS in preventing perforation, hemorrhage, and abdominal pain. The HS is more effective for maintenance of mucosal elevation than saline solution.

CONCLUSIONS

Submucosal injection of HS could not increase the usefulness of en bloc resection and complete resection or seemed not to reduce perforation, hemorrhage, and abdominal pain compared with the saline solution. But, we were able to get benefit from maintenance of mucosal elevation.