title: Comparison of the efficacy of 4- and 8-week lansoprazole treatment for ESD-induced gastric ulcers: a randomized, prospective, controlled study.
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.
authors.affiliation: Department of Internal Medicine, Chung-Ang University College of Medicine, 221 Heukseok-dong, Dongjak-gu, Seoul, 156-756, Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Park
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Baek
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Choi
authors.forename: Kyung Hun
authors.initials: KH
authors.lastname: Lee
authors.forename: Beom Jin
authors.initials: BJ
authors.lastname: Kim
authors.forename: Jeong Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Jae Gyu
authors.initials: JG
authors.lastname: Kim
authors.forename: Sae Kyung
authors.initials: SK
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D004210:Dissection / Q000009:adverse effects; D004334:Drug Administration Schedule; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D064747:Lansoprazole / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000601:surgery; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000209:etiology; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D064747:Lansoprazole