Helicobacter pylori Eradication on the Prevention of Metachronous Lesions after Endoscopic Resection of Gastric Neoplasm: A Meta-Analysis.
BACKGROUND
There is controversy about the effect of Helicobacter pylori (H. pylori) eradication on the prevention of metachronous gastric cancer after endoscopic resection (ER).


OBJECTIVE
The aim of this study was to systematically evaluate the effect of H. pylori eradication on the prevention of metachronous gastric lesions after ER of gastric neoplasms.


METHODS
We performed a systematic search of PubMed, EMBASE, the Cochrane Library, and MEDLINE that encompassed studies through April 2014. Our meta-analysis consisted of 10 studies, which included 5881 patients who underwent ER of gastric neoplasms.


RESULTS
When we compared the incidence of metachronous lesions between H. pylori-eradicated and non-eradicated groups, H. pylori eradication significantly lowered the risk of metachronous lesions after ER of gastric neoplasms (five studies, OR = 0.392, 95% CI 0.259 - 0.593, P < 0.001). When we compared H. pylori-eradicated and persistent groups, again, H. pylori eradication significantly lowered the incidence of metachronous lesions after ER of gastric neoplasms (six studies, OR = 0.468, 95% CI 0.326 - 0.673, P < 0.001). There was no obvious heterogeneity across the analyzed studies.


CONCLUSIONS
This meta-analysis suggests a preventive role for H. pylori eradication for metachronous gastric lesions after ER of gastric neoplasms. Thus, H. pylori eradication should be considered if H. pylori infection is confirmed during ER.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Da Hyun
DH
Jung
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Jie-Hyun
JH
Kim
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Hyun Soo
HS
Chung
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Jun Chul
JC
Park
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Sung Kwan
SK
Shin
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Sang Kil
SK
Lee
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yong Chan
YC
Lee
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D016017:Odds Ratio; D017594:Publication Bias; D013274:Stomach Neoplasms / Q000209:etiology* / Q000601:surgery
D000900:Anti-Bacterial Agents