Document Detail


Optimal Duration of Proton Pump Inhibitor in the Treatment of Endoscopic Submucosal Dissection-Induced Ulcers: A Retrospective Analysis and Prospective Validation Study.
MedLine Citation:
PMID:  22001942     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
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
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-15
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  -     ISSN:  1573-2568     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-Dong, Cheonan, Choongnam, 330-721, Korea.
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