Optimal Duration of Proton Pump Inhibitor in the Treatment of Endoscopic Submucosal Dissection-Induced Ulcers: A Retrospective Analysis and Prospective Validation Study
- Authors
- Lee, Suck-Ho; Lee, Chang Kyun; Chung, Il-Kwun; Shim, Yun Suk; Lee, Tae Hoon; Lee, Sae Hwan; Kim, Hong-Soo; Park, Sang-Heum; Kim, Sun-Joo
- Issue Date
- Feb-2012
- Publisher
- Kluwer Academic/Plenum Publishers
- Keywords
- Endoscopic submucosal dissection; Stomach; Ulcer; Proton pump inhibitors
- Citation
- Digestive Diseases and Sciences, v.57, no.2, pp 429 - 434
- Pages
- 6
- Journal Title
- Digestive Diseases and Sciences
- Volume
- 57
- Number
- 2
- Start Page
- 429
- End Page
- 434
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/15411
- DOI
- 10.1007/s10620-011-1941-2
- ISSN
- 0163-2116
1573-2568
- Abstract
- The optimal duration of proton pump inhibitor (PPI) use in the treatment of endoscopic submucosal dissection (ESD)-induced ulcers has not been well defined. The aim of study was to determine the optimal duration of PPI treatment for ESD-induced gastric ulcers. 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 (a parts per thousand yen40 mm) ESD-induced ulcers according to the duration of PPI treatment (prospective validation). Multivariate logistic regression from a retrospective analysis showed that a duration of PPI treatment < 8 weeks and a post-ESD ulcer a parts per thousand yen40 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 (a parts per thousand yen40 mm) ESD-induced ulcer at 8 weeks follow-up (83.3 vs. 42.6%, P < 0.01). 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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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
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