Abstract | BACKGROUND: The optimal duration of proton pump inhibitor (PPI) use in the treatment of endoscopic submucosal dissection (ESD)-induced ulcers has not been well defined. AIMS: The aim of study was to determine the optimal duration of PPI treatment for ESD-induced gastric ulcers. METHODS: A total of 333 patients who underwent ESD were included in this retrospective analysis and prospective randomized validation. Medical records and endoscopic images for the 221 patients in our ESD-database were reviewed retrospectively. Based on the results of the retrospective analysis, 112 patients with ESD-induced ulcers over 40 mm were randomly assigned to two groups (4- or 8-week course of Lansoprazole 30 mg). Main outcome measurements were to assess the healing-related factors of post-ESD ulcers (retrospective analysis) and to compare complete mucosal healing rate in large (≥ 40 mm) ESD-induced ulcers according to the duration of PPI treatment (prospective validation). RESULTS: Multivariate logistic regression from a retrospective analysis showed that a duration of PPI treatment <8 weeks and a post-ESD ulcer ≥ 40 mm in size were associated with incomplete healing. In a prospective validation, the rate of complete healing in the 8-week PPI group was significantly higher than that of the 4-week PPI group for a large (≥ 40 mm) ESD-induced ulcer at 8 weeks follow-up (83.3 vs. 42.6%, P < 0.01). CONCLUSIONS: The optimal duration of PPI treatment varies based on the initial ulcer size. Patients with an ESD-induced ulcer over 40 mm should be treated with an 8-week course of PPIs.
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Authors | Suck-Ho Lee, Chang Kyun Lee, Il-Kwun Chung, Yun Suk Shim, Tae Hoon Lee, Sae Hwan Lee, Hong-Soo Kim, Sang-Heum Park, Sun-Joo Kim |
Journal | Digestive diseases and sciences
(Dig Dis Sci)
Vol. 57
Issue 2
Pg. 429-34
(Feb 2012)
ISSN: 1573-2568 [Electronic] United States |
PMID | 22001942
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- 2-Pyridinylmethylsulfinylbenzimidazoles
- Enzyme Inhibitors
- Proton Pump Inhibitors
- Lansoprazole
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Topics |
- 2-Pyridinylmethylsulfinylbenzimidazoles
(administration & dosage)
- Aged
- Dissection
(methods)
- Endoscopy, Gastrointestinal
(adverse effects, methods)
- Enzyme Inhibitors
(administration & dosage)
- Female
- Humans
- Lansoprazole
- Logistic Models
- Male
- Middle Aged
- Proton Pump Inhibitors
(administration & dosage)
- Retrospective Studies
- Stomach Neoplasms
(surgery)
- Stomach Ulcer
(drug therapy, etiology)
- Wound Healing
(drug effects)
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