Novel Polymeric Formulation for Removal of Gastrointestinal Polyps by Digestive Endoscopy

Abstract

Abstract: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are two techniques used in resection of gastrointestinal mucosal polyps. The aim of this work was the development and evaluation of an innovative polymeric solution containing sodium carboxymethylcellulose and hyaluronic acid. For this purpose several mixtures of these two main components, as well as others components such as fructose, citric acid and zinc, was evaluated in terms of physicochemical and microbiological properties, rheological behavior, extensibility, syringeability and stability at different storage conditions. Furthermore, the potential production of mucosal elevation and duration was also studied by an ex vivo model using porcine stomach and colon. Results showed that developed polymeric solutions possessed optimal values of pH from 4.58 to 6.63 for its use in the gastrointestinal tract. Formulations exhibited both Newtonian and pseudoplastic behaviors with different viscosity values as a function of their composition. All formulations exhibited high stability properties and no bacterial or fungal growth was detected. MCS01 and MCS05 were the polymeric solutions with best syringeability results. In this line, MCS05 was the formulation that provided the highest, 2.20 ± 0.18 cm and 1.40 ± 0.11 cm, and longest-lasting, for more than 120 min, elevation effect on porcine submucosal stomach and colon tissues, respectively. Thus, it can be concluded that polymeric solution MCS05 might be considered as a promising tool for use in human EMR and ESD.