Severity of gastric mucosal atrophy affects the healing speed of post-endoscopic submucosal dissection ulcers

• 作者: Akira Andoh Atsushi Nishida Hiromitsu Ban Masaki Murata Mitsushige Sugimoto Osamu Inatomi Shigeki Bamba Taketo Otsuka Toshiro Nakata
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: HELICOBACTER pylori GASTRIC mucosal/AB Endoscopic SUBMUCOSAL dissection GASTRIC ULCER
• 年，卷（期）: 2018,（5）
• 页码范围: 83-92
• 页数: 10页
• 分类号: R

摘要

AIM To investigate factors associated with the healing of endoscopic submucosal dissection(ESD)-induced ulcers.METHODS We enrolled 132 patients with gastric tumors scheduled for ESD.Following ESD,patients were treated with daily lansoprazole 30 mg or vonoprazan 20 mg.Ulcer size was endoscopically measured on the day after ESD and at 4 and 8 wk.The gastric mucosa was endoscopically graded according to the Kyoto gastritis scoring system.We assessed the number of patients with and without a 90%reduction in ulcer area at 4 wk post-ESD and scar formation at 8 wk,and looked for risk factors for slower healing.RESULTS The mean size of gastric tumors and post-ESD ulcers was 17.4±12.1 mm and 32.9±13.0 mm.The mean reduction rates in ulcer area were 90.4%±0.8%at 4 wk and 99.8%±0.1%at 8 wk.The reduction rate was associated with the Kyoto grade of gastric atrophy at 4 wk(A0:97.9%±0.6%,A1:93.4%±4.1%,and A2:89.7%±1.0%,respectively).In multivariate analysis,the factor predicting 90%reduction at 4 wk was gastric atrophy(Odds ratio:5.678,95%CI:1.190-27.085,P=0.029).CONCLUSION The healing speed of post-ESD ulcers was associated with the degree of gastric mucosal atrophy,and Helicobacter pylori eradication therapy is required to perform at younger age.