Erschienen in:
01.07.2009 | Original Article
Degree of Healing and Healing-Associated Factors of Endoscopic Submucosal Dissection-Induced Ulcers After Pantoprazole Therapy for 4 Weeks
verfasst von:
Tae-Hoon Oh, Hwoon-Yong Jung, Kee Don Choi, Gin Hyug Lee, Ho June Song, Kwi-Sook Choi, Jun-Won Chung, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim
Erschienen in:
Digestive Diseases and Sciences
|
Ausgabe 7/2009
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Abstract
Background There is no consensus regarding the degree of healing of endoscopic submucosal dissection (ESD)-induced ulcers and the optimal duration of proton pump inhibitor (PPI) treatment. Aim To evaluate the degree of healing and the factors associated with healing of ESD-induced ulcers after PPI therapy for 4 weeks. Methods Fifty-six patients who underwent complete ESD for adenoma or early gastric cancer were enrolled. All patients underwent follow-up endoscopy to evaluate the degree of ulcer healing after pantoprazole therapy (40 mg per day) for 4 weeks. We evaluated change in size of ESD-induced ulcers between baseline and 4 weeks, and correlated relevant factors with degree of healing of small and large ulcers. Results At follow-up, 28 (50%) patients had large ulcers (area > 10 mm2). Ulcer size at 4 weeks was closely correlated with initial ulcer size (P < 0.001) and abruptly increased when initial ulcer size was larger than 4 cm. Comorbidity, procedure time, and initial specimen size were significantly associated with healing rate, but multivariate analysis showed that initial ulcer size was the only significant parameter (P < 0.015). Conclusions Healing degree of ESD-induced ulcers at 4 weeks is dependent on initial ulcer size, indicating that duration of treatment with PPI should be dependent on initial ulcer size.