Risk factors of delayed ulcer healing after gastric endoscopic submucosal dissection View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-03-05

AUTHORS

Joo Hyun Lim, Sang Gyun Kim, Jeongmin Choi, Jong Pil Im, Joo Sung Kim, Hyun Chae Jung

ABSTRACT

BackgroundAlthough post-endoscopic submucosal dissection (ESD) iatrogenic ulcer is known to heal faster than peptic ulcer, some iatrogenic ulcers show delayed healing. The aim of this study was to clarify risk factors of delayed ulcer healing after gastric ESD.MethodsWe retrospectively reviewed medical records of all patients who had ESD for gastric neoplasms (866 adenomas and 814 early gastric cancers) between January 2005 and February 2011.ResultsOf 1680 subjects, 95 had delayed ulcer healing in 3-month follow-up. Multivariate analysis showed that diabetes (OR 1.743; 95 % CI 1.017–2.989, p = 0.043), coagulation abnormality (OR 3.195; 95 % CI 1.535–6.650, p = 0.002), specimen size greater than 4 cm (OR 2.999; 95 % CI 1.603–5.611, p = 0.001), and electrocoagulation (OR 7.149; 95 % CI 1.738–29.411, p = 0.006) were revealed to be independent risk factors of delayed ulcer healing. Meanwhile, persistent Helicobacter pylori infection was not related to the delayed ulcer healing.ConclusionsLarge iatrogenic ulcer by ESD with massive hemostasis, especially in patients with diabetes mellitus or coagulation abnormalities, tends to take more than 3 months to heal. For such cases, initial dosage increment of PPI or addition of other anti-ulcer agents after ESD may be beneficial. More... »

PAGES

3666-3673

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-015-4123-z

DOI

http://dx.doi.org/10.1007/s00464-015-4123-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032844974

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25740642


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