ABSTRACT
Objective To evaluate the efficacy and safety of magnesium aluminum suspension spraying in treating gastric ulcer after endoscopic submocosal dissection (ESD). Methods We made a prospective analysis of patients with gastric ESD surgery performed between January 2016 and June 2019. They were divided into control group, spraying group, and spraying + oral group on the basis of treatment method. All patients were followed up for 8 weeks to evaluate endoscopic ulcer healing and recovery rate. At the same time, postoperative symptoms and complications such as bleeding were also recorded. SPSS 24.0 software was used for statistical analysis. Results A total of 330 eligible cases were randomly divided into control group (124 cases), spraying group (108 cases), and spraying + oral group (98 cases). The results showed that the postoperative pain incidence in spraying group and spraying + oral group was significantly better than that in the control group (35.48% vs. 17.59%, P<0.01; 35.48% vs. 20.41%, P=0.01). The 4-week ulcer recovery rate was better in spraying + oral group than in the control group. It should be noted that ulcer healing rate achieved 100% for the antrum of patients in spraying + oral group. At the same time, the incidence of postoperative bleeding decreased, and no significant adverse drug reactions were observed during the follow-up. Conclusion Almagate suspension spraying is safe and effective in the treatment of upper gastrointestinal ESD postoperative ulcer. In addition, it can also relieve postoperative pain.
ABSTRACT
BACKGROUND/AIMS: Helicobacter pylori eradication may facilitate the healing of iatrogenic ulcer after endoscopic resection of gastric neoplasm. This study involved designing a randomized, double-blinded, placebo-controlled, multicenter trial, performed by the Korean College of Helicobacter and Upper Gastrointestinal Research and the Medical Research Collaboration Center, Seoul National University Hospital. METHODS: We intend to enroll up to 232 patients H.-pylori-positive patients who have gastric adenoma or early gastric cancer after endoscopic resection. The enrolled patients are being randomly allocated to the H.-pylori-eradication-plus-proton-pump-inhibitor group or the placebo-plus-proton-pump-inhibitor group based on their histology results and the size of the resected specimen. After random allocation, the iatrogenic ulcer size and stage are evaluated at 4- and 8-week follow-ups (with a window of +/-7 days). The primary end point is the healing rate of the ulcer by stage, and the secondary end point is the rate of ulcer size reduction, relief rate from ulcer-related symptoms, and adverse-event rates. RESULTS: More than 90% of the target subjects have already been enrolled into the study and are receiving ongoing periodic monitoring by the Medical Research Collaboration Center. CONCLUSIONS: Completion of the study should reveal whether H. pylori eradication can facilitate the healing of ulcer after endoscopic resection in Korea.