Degree of healing and healing-associated factors of endoscopic submucosal dissection-induced ulcers after pantoprazole therapy for 4 weeks.
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.
Oh
Tae-Hoon
TH
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, South Korea.
Jung
Hwoon-Yong
HY
Choi
Kee Don
KD
Lee
Gin Hyug
GH
Song
Ho June
HJ
Choi
Kwi-Sook
KS
Chung
Jun-Won
JW
Byeon
Jeong-Sik
JS
Myung
Seung-Jae
SJ
Yang
Suk-Kyun
SK
Kim
Jin-Ho
JH
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
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D000077402:Pantoprazole