# Feasibility of a novel self‐assembling submucosal injection peptide solution for endoscopic mucosal resection of colorectal lesions: A multicenter study

## TL;DR

A new synthetic peptide solution called PuraLift was tested for use in endoscopic mucosal resection of colorectal lesions, showing high effectiveness and safety in a multicenter study.

## Contribution

This study is the first to evaluate the clinical feasibility of the self-assembling peptide solution PuraLift for endoscopic mucosal resection in multiple centers.

## Key findings

- PuraLift achieved a 99% en-bloc resection rate and a 93% complete resection rate for colorectal lesions.
- The effective injection rate was 93%, with minimal need for additional injections.
- No adverse events were reported during the study period.

## Abstract

Although a novel submucosal injection material consisting of a fully synthetic, self‐assembling peptide solution, PuraLift, has recently become commercially available in Japan, there are a few reports regarding the usefulness of this solution. The aim of this study was to investigate the feasibility of PuraLift for conventional endoscopic mucosal resection (EMR) in clinical practice.

This multicenter retrospective study was conducted at the endoscopy units of five institutions from January 2023 to May 2023. Consecutive patients who underwent EMR with PuraLift for 5–20‐mm colorectal lesions were included in the introduction of this solution at each institute. The primary endpoint was the “effective resection” rate, defined as pathological complete resection, with “effective injection” defined as requiring no more than one additional injection due to adequate maintenance of mucosal lifting during EMR.

In total, 110 lesions in 70 patients were treated by conventional EMR using PuraLift. En‐bloc resection was performed for 109 (99%) lesions, and complete resection was performed for 102 (93%) lesions. More than 95% of the lesions were neoplastic. Additional injections were required in only two lesions. Both were single additional injections, and the median overall injection volume was 1.5 mL. Therefore, the effective injection rate was 93% (95% confidence interval, 86%–96%). No adverse events occurred during the study period.

Although direct comparison with other materials is required, PuraLift seems feasible as an injection material for EMR.