title: Oral rabeprazole administration on a procedure day suppresses bleeding after endoscopic submucosal dissection for gastric neoplasms.
abstract: OBJECTIVE
  The efficacy of pre-procedure oral proton pump inhibitor (PPI) administration for gastric endoscopic submucosal dissection (ESD) is unclear. This study evaluated oral PPI administration effectiveness on the day of ESD to prevent post-ESD bleeding.
  
  
  METHODS
  This study examined 55 patients who underwent ESD for gastric neoplasm. Group A comprised 31 patients who took rabeprazole sodium (RPZ) 20 mg/day beginning 7-8 hr before ESD. Group B comprised 24 who took RPZ 20 mg/day beginning three days before ESD. Gastric pH (G-pH) was measured at one month before ESD (pre-ESD pH), immediately before ESD (ESD pH), and seven days after ESD (post-ESD pH). The post-ESD bleeding rate and changes in G-pH were recorded.
  
  
  RESULTS
  No significant difference in post-ESD bleeding rates was found (Group A 3.2%, Group B 0%). ESD pH and post-ESD pH were significantly higher than pre-ESD pH in both groups (P<0.001). The ESD pH for Group A was higher than 6 (6.5±1.1), providing hemostasis for intragastric bleeding.
  
  
  CONCLUSIONS
  Oral RPZ administration on the day of gastric ESD can suppress post-ESD bleeding equivalently to administration three days before ESD.
authors.affiliation: Department of Endoscopy, Fukushima Medical University Hospital.
authors.forename: Takuto
authors.initials: T
authors.lastname: Hikichi
authors.forename: Masaki
authors.initials: M
authors.lastname: Sato
authors.forename: Ko
authors.initials: K
authors.lastname: Watanabe
authors.forename: Jun
authors.initials: J
authors.lastname: Nakamura
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Takagi
authors.forename: Rei
authors.initials: R
authors.lastname: Suzuki
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Waragai
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Konno
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Obara
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000236:Adenoma / Q000601:surgery; D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control*; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D064750:Rabeprazole / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000601:surgery*
chemical_list: D054328:Proton Pump Inhibitors; D064750:Rabeprazole