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首页> 外文期刊>Acta biomaterialia >Poly(lactic acid-co-glycolic acid)-poly(ethylene glycol)-poly(lactic acid-co-glycolic acid) thermogel as a novel submucosal cushion for endoscopic submucosal dissection
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Poly(lactic acid-co-glycolic acid)-poly(ethylene glycol)-poly(lactic acid-co-glycolic acid) thermogel as a novel submucosal cushion for endoscopic submucosal dissection

机译：聚（乳酸-乙醇酸）-聚（乙二醇）-聚（乳酸-乙醇酸）热凝胶作为用于内镜黏膜下剥离的新型黏膜下垫

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摘要

Endoscopic submucosal dissection (ESD) is a clinical therapy for early stage neoplastic lesions in the gastrointestinal tract. It is, however, faced with a crucial problem: the high occurrence of perforation. The formation of a submucosal fluid cushion (SFC) via a fluid injection is the best way to avoid perforation, and thus an appropriate biomaterial is vital for this minimally invasive endoscopic technique. In this study, we introduced an injectable thermogel as a novel submucosal injection substance in ESD. The hydrogel synthesized by us was composed of poly(lactic acid-co-glycolic acid)-poly(ethylene glycol)-poly(lactic acid-co-glycolic acid) (PLGA-PEG-PLGA) triblock copolymers. The polymer/water system was a low-viscosity fluid at room temperature and thus easily injected, and turned into a non-flowing gel at body temperature after injection. The submucosal injection of the thermogel to create SFCs was performed in both resected porcine stomachs and living minipigs. High mucosal elevation with a clear margin was maintained for a long duration. Accurate en bloc resection was achieved with the assistance of the thermogel. The mean procedure time was strikingly reduced. Meanwhile, no obvious bleeding, perforation and tissue damage were observed. The application of the thermogel not only facilitated the ESD procedure, but also increased the efficacy and safety of ESD. Therefore, the PLGA-PEG-PLGA thermogel provides an excellent submucosal injection system, and has great potential to improve the ESD technique significantly.
机译：内镜黏膜下剥离术（ESD）是胃肠道早期肿瘤性病变的临床治疗方法。但是，它面临着一个关键问题：穿孔的发生率很高。通过注液形成粘膜下液垫（SFC）是避免穿孔的最佳方法，因此合适的生物材料对于这种微创内窥镜技术至关重要。在这项研究中，我们介绍了一种可注射的热凝胶，它是ESD中一种新型的粘膜下注射物质。我们合成的水凝胶由聚（乳酸-乙醇酸共聚物）-聚（乙二醇）-聚乳酸-乙醇酸共聚物（PLGA-PEG-PLGA）三嵌段共聚物组成。聚合物/水体系在室温下为低粘度流体，因此易于注射，注射后在体温下变成不流动的凝胶。在切除的猪胃和活体小猪中均进行了热凝胶的粘膜下注射以产生SFC。长期保持高粘膜升高和清晰的边缘。借助热凝胶可以实现精确的整块切除。平均手术时间显着减少。同时，未观察到明显的出血，穿孔和组织损伤。热凝胶的应用不仅简化了ESD程序，而且提高了ESD的功效和安全性。因此，PLGA-PEG-PLGA热凝胶提供了出色的粘膜下注射系统，并具有极大地改善ESD技术的巨大潜力。

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