Comparison of the efficacy of 4- and 8-week lansoprazole treatment for ESD-induced gastric ulcers: a randomized, prospective, controlled study.

Abstract

BACKGROUND:

Although endoscopic submucosal dissection (ESD) is widely used to treat gastric neoplasms, there is no consensus for the optimal treatment for ESD-induced ulcers. We compared efficacy between 4 and 8 weeks of lansoprazole treatment for iatrogenic gastric ulcers that developed after ESD.

METHODS:

Eighty-four patients who were diagnosed with gastric adenoma or early gastric cancer were enrolled and randomly assigned to treatment with lansoprazole (30 mg/day) for 4 or 8 weeks. Eight weeks after ESD, we conducted follow-up endoscopy to compare ulcer stage and ulcer reduction ratio (dividing the ulcer dimension at 8 weeks by the initial ulcer dimension) between the two groups.

RESULTS:

From the 84 patients, 69 patients were included in the final analysis, with 34 in the 4-week group and 35 in the 8-week group. Eight weeks after ESD, there were no significant difference observed between the two groups in terms of the ulcer stage (68 % in the scar stage in the 4-week group vs. 69 % in the 8-week group, P = 0.93) or the ulcer reduction ratio (0.0081 ± 0.015 in the 4-week group vs. 0.0037 ± 0.008 in the 8-week group, P = 0.15). Also, in the subgroup analysis among the patients with large ulcers (>30 mm), those parameters were not different.

CONCLUSIONS:

For ESD-induced gastric ulcers, treatment with lansoprazole for 4 weeks was as effective as treatment for 8 weeks. Considering cost-effectiveness, proton pump inhibitor therapy for 4 weeks may be sufficient for ESD-induced gastric ulcers.

• Authors: Ji Hoon Park, Eun Kyung Baek, Chang Hwan Choi, Kyung Hun Lee, Beom Jin Kim, Jeong Wook Kim, Jae Gyu Kim, Sae Kyung Chang
• Journal: Surgical endoscopy (Surg Endosc) Vol. 28 Issue 1 Pg. 235-41 (Jan 2014) ISSN: 1432-2218 [Electronic] Germany
• PMID: 23996340 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Ulcer Agents
• Proton Pump Inhibitors
• Lansoprazole

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Ulcer Agents (administration & dosage)
• Dissection (adverse effects)
• Drug Administration Schedule
• Endoscopy (adverse effects)
• Female
• Gastroscopy (adverse effects)
• Humans
• Lansoprazole (administration & dosage)
• Male
• Middle Aged
• Postoperative Complications (drug therapy, etiology)
• Prospective Studies
• Proton Pump Inhibitors (administration & dosage)
• Stomach Neoplasms (surgery)
• Stomach Ulcer (drug therapy, etiology)
• Wound Healing (drug effects)