title: Prospective single-arm trial of two-week rabeprazole treatment for ulcer healing after gastric endoscopic submucosal dissection.
abstract: OBJECTIVE
  Endoscopic submucosal dissection (ESD) causes artificial ulcers, and there is no consensus regarding the degree of healing in ESD-induced ulcers or the optimal duration of proton pump inhibitor (PPI) treatment. The aim of the present study was to investigate the healing rates of post-ESD ulcers in response to the protective effect of 2-week PPI treatment.
  
  
  METHODS
  Between February 2007 and March 2010, 75 patients/75 lesions and 55 patients/55 lesions were enrolled as interim and per-protocol groups, respectively. All patients were prescribed rabeprazole (10 mg/day) orally for 16 days beginning on the day before ESD. Follow-up endoscopy was carried out 8 weeks after ESD to evaluate ulcer healing. The primary end-point was the healing rate of post-ESD ulcers at 8 weeks after ESD. Secondary end-points were the rate of post-ESD bleeding with emergency endoscopy and the rate of other severe adverse effects during the study period.
  
  
  RESULTS
  The transitional rate to scarring-stage ulcers was 80.0% (44/55). Location in the lesser curve and large resected size (>40 mm) were statistically significant predictors for delayed ulcer healing by univariate analysis and the latter was still significant by the multivariate analysis. Post-ESD bleeding occurred within 2 weeks in two cases (2.7%), but both cases were successfully managed with endoscopic hemostasis only. Severe adverse effects did not occur.
  
  
  CONCLUSIONS
  Two-week administration of PPI for post-ESD gastric ulcers may be sufficient to aid healing without increasing any adverse effects in cases where there are no possible deteriorating factors on ulcer healing, although large resection and/or resection in the lesser curve may result in delayed healing even after 8 weeks of ESD.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Niimi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.forename: Osamu
authors.initials: O
authors.lastname: Goto
authors.forename: Shinya
authors.initials: S
authors.lastname: Kodashima
authors.forename: Chihiro
authors.initials: C
authors.lastname: Minatsuki
authors.forename: Itsuko
authors.initials: I
authors.lastname: Hirayama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mochizuki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Nobutake
authors.initials: N
authors.lastname: Yamamichi
authors.forename: Naomi
authors.initials: N
authors.lastname: Kakushima
authors.forename: Masao
authors.initials: M
authors.lastname: Ichinose
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D002278:Carcinoma in Situ / Q000601:surgery*; D004210:Dissection; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D064750:Rabeprazole; D013274:Stomach Neoplasms / Q000601:surgery*; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000209:etiology; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064750:Rabeprazole