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Surgical Endoscopy
Published in: Surgical Endoscopy 1/2014

01-01-2014

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

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

Published in: Surgical Endoscopy | Issue 1/2014

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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.
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Metadata
Title
Comparison of the efficacy of 4- and 8-week lansoprazole treatment for ESD-induced gastric ulcers: a randomized, prospective, controlled study
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
Publication date
01-01-2014
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 1/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3177-z

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