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Gastroenterology Research and Practice
Volume 2015, Article ID 702768, 10 pages
Review Article

Submucosal Injection Solution for Endoscopic Resection in Gastrointestinal Tract: A Traditional and Network Meta-Analysis

Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China

Received 26 October 2014; Revised 5 December 2014; Accepted 5 December 2014

Academic Editor: Peter V. Draganov

Copyright © 2015 Zhang Yu Huai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To explore and define the current optimal submucosal injection solution used in ESD and EMR for gastrointestinal tract neoplasms in terms of clinical outcomes and other aspects. Methods. PubMed, Cochrane Library, Embase, and clinical trials register center were searched with terms of “endoscopic resection” and “submucosal injection solution” to identify relevant randomized controlled trials (RCTs). Both direct comparison using traditional meta-analysis method and indirect comparison using network meta-analysis method were performed. Results. A total of 11 RCTs with 1152 patients were included. Meta-analysis showed that, compared with normal saline, other submucosal injection solutions induced a significant increase in terms of en bloc resection rate %, OR = 2.11, 95% CI (1.36, 3.26), and and complete resection rate %, OR = 2.14, 95% CI (1.41, 3.24), and ; and there was no significant difference in the incidence of total complications %, OR = 0.87, 95% CI (0.59, 1.29), and . Conclusions. Other newly developed submucosal injection solutions significantly increased en bloc resection rate and complete resection rate and decreased bleeding rate and finical cost of endoscopic resection in gastrointestinal tract, while current evidence did not find the difference between them, which need to be explored by further studies.