Rex, Douglas K.Broadley, Heather M.Garcia, Jonathan R.Lahr, Rachel E.MacPhail, Margaret E.McWhinney, Connor D.Searight, Meghan P.Sullivan, Andrew W.Mahajan, NealEckert, George J.Vemulapalli, Krishna C.2019-09-092019-09-092019Rex, D. K., Broadley, H. M., Garcia, J. R., Lahr, R. E., MacPhail, M. E., McWhinney, C. D., … Vemulapalli, K. C. (2019). SIC-8000 versus hetastarch as a submucosal injection fluid for endoscopic mucosal resection: A randomized controlled trial. Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2019.06.040https://hdl.handle.net/1805/20895Background and Aims Viscous solutions provide a superior submucosal cushion for endoscopic mucosal resection (EMR). SIC-8000 (Eleview, Aries Pharmaceuticals, La Jolla, Calif) is a commercially available FDA approved solution but hetastarch is also advocated. We performed a randomized trial comparing SIC-8000 to hetastarch as submucosal injection agents for colorectal EMR. Methods This was a single-center double-blinded randomized controlled trial performed at a tertiary referral center. Patients were referred to our center with flat or sessile lesions measuring ≥15 mm in size. The primary outcome measures were the Sydney Resection Quotient (SRQ) and the rate of en bloc resections. Secondary outcomes were total volume needed for a sufficient lift, number of resected pieces, and adverse events. Results There were 158 patients with 159 adenomas (84 SIC-8000 and 75 hetastarch) and 57 serrated lesions (30 SIC-8000 and 27 hetastarch). SRQ was significantly better in the SIC-8000 group compared with hetastarch group (9.3 vs 8.1, p=0.001). There was no difference in the proportion of lesions with en bloc resections. The total volume of injectate was significantly lower with SIC-8000 (14.8 mL vs 20.6 mL, p=0.038) Conclusions SIC-8000 is superior to hetastarch for use during EMR in terms of SRQ and total volume needed, although the absolute differences were small.enPublisher Policyendoscopic mucosal resectionSIC-8000hetastarchArticle