Unsuspected efficacy of starch-based polysaccharide vs crystalloid-oil emulsion for lifting in colonic endoscopic resections

Table 1 Demographics and pathological findings, n (%)

Outcome	Submucosal injection group
	Starch-based polysaccharide solution group	Crystalloid-oil emulsion solution group	t-test/χ2 statistic	P value
Gender
Males	52/99 (52.5)	45/79 (56.9)	0.34	0.55
Females	47/99 (47.4)	34/79 (43.0)
Age
Mean age	66	68	2.69 (t-test)	0.32
Pathologic diagnosis
Adenoma	44/99 (44.4)	43/79 (54.4)	1.75	0.41
Sessile serrated adenoma/hyperplastic polyp	46/99 (46.4)	30/79 (37.9)
Adenocarcinoma	9/99 (9.1)	6/79 (7.6)

Table 2 Clinical/endoscopic data of study cases, n (%)

Outcome	Submucosal injection group
	Starch-based polysaccharide solution group	Crystalloid-oil emulsion solution group	χ2 statistic	P value
Polypectomy technique
Endoscopic mucosal resection	75/99 (75.7)	73/79 (92.4)	8.69	< 0.01
Endoscopic submucosal dissection	24/99 (24.2)	6/79 (7.6)
Polyp location
Right colon	63/99 (63.6)	42/79 (53.2)	1.99	0.16
Left colon	36/99 (36.3)	37/79 (46.8)
Polyp size
< 2 cm	28/99 (28.2)	26/79 (32.9)	3.21	0.20
2-4 cm	45/99 (45.5)	41/79 (51.9)
≥ 4 cm	26/99 (26.2)	12/79 (15.2)
Quality of lift
Adequate	71/99 (71.7)	57/79 (72.2)	1.30	0.52
Not adequate	12/99 (12.1)	13/79 (16.5)
Not reported	16/99 (16.6)	9/79 (11.4)
Polypectomy resection
En bloc	32/99 (32.3)	8/79 (10.1)	12.43	< 0.01
Piecemeal	67/99 (67.7)	71/79 (89.9)
Intraprocedural bleeding requiring intervention
Yes	20/99 (20.2)	35/79 (44.3)	11.95	< 0.01
No	79/99 (79.8)	44/79 (55.7)
30-day adverse events
Rectal bleeding	2/99 (2.0)	7/79 (8.9)	6.65	< 0.01
Bowel perforation	0/99 (0.0)	2/79 (2.5)

P values were derived from χ² tests comparing the occurrence of each outcome between the two study groups.

Table 3 Comparison of average duration of procedure between starch-based polysaccharide solution and crystalloid-oil emulsion solution groups, n (%)

Outcome	Starch-based polysaccharide solution group	Crystalloid-oil emulsion solution group	t-test/χ2 statistic	P value
Average duration of procedure (minute)	96 ± 45.18	117 ± 57.57	2.76 (t-test)	< 0.01
Intraprocedural bleeding requiring intervention	10/99 (10.1)	35/79 (44.3)	27.21	< 0.01
En bloc resection	32/99 (32.3)	8/79 (10.1)	12.43	< 0.01
30-day adverse events	2/99 (2.0)	9/79 (11.4)	6.66	0.01

P values were derived from t-test and χ² test comparing the occurrence of each outcome between the two study groups.

Table 4 Comparison of outcomes with different frequencies between starch-based polysaccharide solution and crystalloid-oil emulsion solution groups, n (%)

Occurrences and frequencies of measured outcomes	Submucosal injection group: Right-sided colon
	Starch-based polysaccharide solution	Crystalloid-oil emulsion solution	χ2 statistic	P value
Any size
Intraprocedural bleeding requiring intervention	8/63 (12.7)	15/42 (35.7)	7.80	< 0.01
En bloc resection	21/63 (33.3)	6/42 (14.3)	4.79	0.02
Adverse events	0/63 (0.0)	3/42 (7.1)	NS	NS
< 2 cm
Intraprocedural bleeding requiring intervention	0/16 (0.0)	0/17 (0.00)	NS	NS
En bloc resection	1/16 (6.3)	4/17 (23.5)	1.91	0.16
Adverse events	0/16 (0.0)	1/17 (5.9)	NS	NS
2-4 cm
Intraprocedural bleeding requiring intervention	8/47 (17.0)	15/24 (62.5)	15.00	< 0.01
En bloc resection	20/47 (42.6)	2/24 (8.3)	8.69	< 0.01
Adverse events	0/47 (0.0)	2/24 (8.3)	NS	NS
≥ 4 cm
Intraprocedural bleeding requiring intervention	3/17 (17.7)	4/5 (80.0)	6.92	< 0.01
En bloc resection	10/17 (58.8)	1/5 (20.0)	2.33	0.13
Adverse events	0/17 (0.0)	0/5 (0.0)	NS	NS

P values were derived from χ² test comparing the occurrence of each outcome between the two study groups. NS: Not significant.

Table 5 Comparison between starch-based polysaccharide solution and crystalloid-oil emulsion solution groups by location and size, n (%)

Occurrences and frequencies of measured outcomes	Submucosal injection group: Right-sided colon
	Starch-based polysaccharide solution	Crystalloid-oil emulsion solution	χ2 statistic	P value
Any size
Intraprocedural bleeding requiring intervention	8/63 (12.7)	15/42 (35.7)	7.80	< 0.01
En bloc resection	21/63 (33.3)	6/42 (14.3)	4.79	0.02
Adverse events	0/63 (0.0)	3/42 (7.1)	NS	NS
< 2 cm
Intraprocedural bleeding requiring intervention	0/16 (0.0)	0/17 (0.00)	NS	NS
En bloc resection	1/16 (6.3)	4/17 (23.5)	1.91	0.16
Adverse events	0/16 (0.0)	1/17 (5.9)	NS	NS
2-4 cm
Intraprocedural bleeding requiring intervention	8/47 (17.0)	15/24 (62.5)	15.00	< 0.01
En bloc resection	20/47 (42.6)	2/24 (8.3)	8.69	< 0.01
Adverse events	0/47 (0.0)	2/24 (8.3)	NS	NS
≥ 4 cm
Intraprocedural bleeding requiring intervention	3/17 (17.7)	4/5 (80.0)	6.92	< 0.01
En bloc resection	10/17 (58.8)	1/5 (20.0)	2.33	0.13
Adverse events	0/17 (0.0)	0/5 (0.0)	NS	NS

P values were derived from χ² tests comparing the occurrence of each outcome between the two study groups. NS: Not significant.