Table 1.

Submucosal injection solutions for EMR/ESD

Normal Saline (NS) Solution	– Commonly used, but fluid cushion not long-lasting
Hypertonic Saline Solution	– Hypertonic solution
Glycerol3,11,12	– Facilitates easier and safer EMR/ESD at low cost
Dextrose Water (DW)10	– Cheaper hypertonic solution, but likelihood of tissue damage in concentrations ≥20%
Hyaluronic Acid (HA)4–6,13,14	– Produces and maintains long-lasting fluid cushion, but high cost and limited availability
Fibrinogen Mixture (FM)15,16	– High viscosity and reasonable cost, but risk of virus transmission
Hydroxypropyl Methylcellulose (HPMC)17–19	– Produces long-lasting fluid cushion, inexpensive and readily available, but detailed toxicity testing necessary

Abbreviations: EMR, endoscopic mucosal resection; ESD, endoscopic submucosal resection.