title: Degree of healing and healing-associated factors of endoscopic submucosal dissection-induced ulcers after pantoprazole therapy for 4 weeks.
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.
  
  
  OBJECTIVE
  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 mm(2)). 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.
authors.affiliation: Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, South Korea.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Oh
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Ho June
authors.initials: HJ
authors.lastname: Song
authors.forename: Kwi-Sook
authors.initials: KS
authors.lastname: Choi
authors.forename: Jun-Won
authors.initials: JW
authors.lastname: Chung
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D000230:Adenocarcinoma / Q000601:surgery; D000236:Adenoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D004210:Dissection; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D015999:Multivariate Analysis; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000601:surgery*; D013276:Stomach Ulcer / Q000188:drug therapy*; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D000077402:Pantoprazole