Method of endoscopic mucosal resection using mucopolysaccharide and local injection preparation

• US 6,319,260 B1
• Filed: 05/16/2000
• Issued: 11/20/2001
• Est. Priority Date: 01/11/2000
• Status: Active Grant

• Current Assignee: Hironori Yamamoto
• Original Assignee: Hironori Yamamoto
• Inventors: Yamamoto, Hironori
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US09/570,515
• Time in Patent Office: 553 Days
• Field of Search: 606/113, 606/110, 606/37, 606/46, 606/79, 606/148, 600/101, 600/104, 600/153, 600/156, 514/44, 424/93.2, 435/320.1
• US Class Current: 606/113
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61K 2300/00 Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
• CPC Class Codes: A61K 31/135 having aromatic rings , e.g. ketamine, nortriptyline methadone A61K31/137
• CPC Class Codes: A61K 31/728 Hyaluronic acid
• CPC Class Codes: A61K 31/737 Sulfated polysaccharides, e.g. chondroitin sulfate, dermatan sulfate A61K31/727 takes precedence
• CPC Class Codes: A61P 7/04 Antihaemorrhagics; Procoagulants; Haemostatic agents; Antifibrinolytic agents

Abstract

Endoscopic mucosal resection is performed by the steps of injecting a local injection preparation containing a biocompatible mucoploysaccharide having no anticoagulant activity, preferably sodium hyaluronate, into the submucosal layer of an affected mucosal tissue to create mucosal elevation, and then, trapping the thus-elevated mucosal tissue with a snare to perform resection. Preferably the local injection preparation further contains a hemostat or angiotonic, and a pharmaceutically acceptable dyestuff.

Claims

1. A method of endoscopic mucosal resection, which comprises injecting a local injection preparation containing a biocompatible mucopolysaccharide having no anticoagulant activity into the submucosal layer of an affected mucosal tissue to create mucosal elevation, and

trapping the thus-elevated mucosal tissue with a snare to perform resection.

2. The method of endoscopic mucosal resection according to claim 1, wherein the biocompatible mucopolysaccharide is selected from the group consisting of hyaluronic acid and pharmaceutically acceptable salts thereof, chondroitin sulfate and cartilage proteoglycan.

3. The method of endoscopic mucosal resection according to claim 1, wherein the biocompatible mucopolysaccharide is sodium hyaluronate.

4. The method of endoscopic mucosal resection according to claim 1, wherein the local injection preparation contains sodium hyaluronate having an average molecular weight of 20,000 to 4,000,000 at a concentration of 0.2 to 1.0% weight/volume.

5. The method of endoscopic mucosal resection according to claim 1, wherein the local injection preparation contains sodium hyaluronate having an average molecular weight of 600,000 to 1,200,000 at a concentration of 0.2 to 1.0% weight/volume.

6. The method of endoscopic mucosal resection according to claim 1, wherein the local injection preparation further contains a hemostat or angiotonic.

7. The method of endoscopic mucosal resection according to claim 6, wherein the hemostat or angiotonic is epinephrine.

8. The method of endoscopic mucosal resection according to claim 7, wherein the local injection preparation is an aqueous sodium hyaluronate solution containing 0.001 to 0.1 mg/ml of epinephrine.

9. The method of endoscopic mucosal resection according to claim 1, wherein the local injection preparation further contains a pharmaceutically acceptable dyestuff.

10. The method of endoscopic mucosal resection according to claim 1, which is a method for excision of a nonpolypold early neoplastic lesion of gastrointestinal tract, comprising injecting the biocompatible mucopolysaccharide-containing local injection preparation into the submucosal layer of the neoplastic lesion to create mucosal elevation, followed by trapping the thus-elevated mucosa with a snare to perform resection.

11. A local injection preparation for endoscopic mucosal resection which comprises a biocompatible mucopolysaccharide having no anticoagulant activity, and a hemostat or angiotonic;

the amount of the biocompatible mucopolysaccharide being such that the injection preparation has a viscosity suitable for endoscopic submucosal injection.

12. The local injection preparation according to claim 11, wherein the biocompatible mucopolysaccharide is selected from the group consisting of hyaluronic acid and phamaceutically acceptable salts thereof, chondroitin sulfate and cartilage proteoglycan.

13. The local injection preparation according to claim 11, wherein the biocompatible mucopolysaccharide is sodium hyaluronate.

14. The local injection preparation according to claim 11, wherein the local injection preparation contains sodium hyaluronate having an average molecular weight of 20,000 to 4,000,000 at a concentration of 0.2 to 1.0% weight/volume.

15. The local injection preparation according to claim 11, wherein the local injection preparation contains sodium hyaluronate having an average molecular weight of 600,000 to 1,200,000 at a concentration of 0.2 to 1.0% weight/volume.

16. The local injection preparation according to claim 11, wherein the hemostat or angiotonic is epinephrine.

17. The local injection preparation according to claim 16, wherein the local injection preparation in an aqueous sodium hyaluronate solution containing 0.001 to 0.1 mg/ml of epinephrine.

18. The local injection preparation according to claim 11, wherein the local injection preparation further contains a pharmaceutically acceptable dyestuff.