Author： Lee Suck-Ho Lee Chang Chung Il-Kwun Shim Yun Lee Tae Lee Sae Kim Hong-Soo Park Sang-Heum Kim Sun-Joo
Publisher： Springer Publishing Company
ISSN： 0163-2116
Source： Digestive Diseases and Sciences, Vol.57, Iss.2, 2012-02, pp. : 429-434
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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 (≥40 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 ≥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%,
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