Does Mesna Facilitate Endoscopic Submucosal Dissection of Gastric Cancers?

Superficial gastric neoplastic lesions are commonly treated in Asia using endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Subcutaneous injection of saline has been used to facilitate EMR, but it quickly disperses, which has led to use of longer-acting agents to create a fluid cushion for ESD. Results of animal studies and a small pilot study suggest that mesna (sodium 2-sulfanylethanesulfonate) — a compound used for other medical indications — disrupts disulfide bonds, softening connective tissue, and may facilitate ESD. Now, investigators at a single hospital in Japan have compared the performance of mesna with saline in 100 patients undergoing ESD for 105 superficial gastric cancers.

Patients were randomized i…