title: Short-term healing process of artificial ulcers after gastric endoscopic submucosal dissection.
abstract: OBJECTIVE
  The relationship between the appearance of an ulcer and postoperative bleeding after gastric endoscopic submucosal dissection (ESD) is not well understood. To explore this potential relationship, we retrospectively analyzed the short-term healing process of ESD.
  
  
  METHODS
  A total of 520 consecutive lesions in 434 patients seen between January 2004 and December 2009 were retrospectively investigated. At the second-look endoscopy, which occurred between 1 and 8 days after ESD, artificial ulcers were categorized into 6 patterns according to Forrest's classification: spurting bleeding, oozing bleeding, non-bleeding visible vessel, adherent clot, black base/spot, and clean base. From these data, a short-term healing model of the artificial ulcer was generated.
  
  
  RESULTS
  Ulcer base changed gradually from a bloody to a clean one. The bleeding or non-bleeding visible vessel categories, which occurred in approximately one quarter of the ulcers within 3 days of ESD, were rarely observed 4 days after ESD.
  
  
  CONCLUSIONS
  Ulcers that occur after gastric ESD heal in line with a specific time course, and it appears that most healing occurs without massive bleeding.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Goto
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.forename: Shinya
authors.initials: S
authors.lastname: Kodashima
authors.forename: Chihiro
authors.initials: C
authors.lastname: Minatsuki
authors.forename: Keiko
authors.initials: K
authors.lastname: Niimi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Nobutake
authors.initials: N
authors.lastname: Yamamichi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike