Helicobacter pylori status and the extent of gastric atrophy do not affect ulcer healing after endoscopic submucosal dissection

Naomi Kakushima, Mitsuhiro Fujishiro, Naohisa Yahagi, Shinya Kodashima, Masanori Nakamura, Masao Omata

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background: Eradication therapy for Helicobacter pylori is effective in preventing peptic ulcer recurrence, but its efficacy in ulcer healing is still controversial. The effect of H. pylori on artificial ulcers after endoscopic resection is not known. The purpose of the present study was therefore to evaluate the influence of H. pylori infection on ulcer healing after endoscopic submucosal dissection (ESD). Methods: One hundred and 10 patients who underwent ESD for gastric tumors, and for whom the infection status of H. pylori was confirmed before treatment, were included. The healing stage was studied by endoscopy performed at 8 weeks after ESD. In addition, 73 patients whose serum pepsinogen (PG) was evaluated before ESD, were divided into three groups: PG positive (PGI ≤ 70 ng/mL and I/II ≤ 3 ng/mL), strongly positive (PGI ≤ 30 ng/mL and I/II ≤ 2 ng/mL) and negative, to study the influence of atrophic gastritis on ulcer healing. Results: Ulcer healing was observed in 85 patients (93%) who were H. pylori positive, and in 19 patients (100%) in whom H. pylori had been eradicated previously. Serum PG level had no influence on the healing process. Among 15 patients with ulceration or ulcer scar with the lesion, ulcer healing was observed in nine patients (60%), which was significantly low. Conclusions: Infection status of H. pylori and the extent of gastric atrophy do not affect ulcer healing after ESD. Preoperative existence of fibrotic change in the submucosal layer may delay the healing process.

Original languageEnglish
Pages (from-to)1586-1589
Number of pages4
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume21
Issue number10
DOIs
Publication statusPublished - 2006
Externally publishedYes

Fingerprint

Helicobacter pylori
Ulcer
Atrophy
Stomach
Pepsinogen A
Atrophic Gastritis
Endoscopic Mucosal Resection
Helicobacter Infections
Infection
Serum
Peptic Ulcer
Endoscopy
Cicatrix
Recurrence
Therapeutics
Neoplasms

Keywords

  • Artificial ulcer
  • Atrophic gastritis
  • Endoscopic submucosal dissection (ESD)
  • Helicobacter pylori
  • Pepsinogen

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Helicobacter pylori status and the extent of gastric atrophy do not affect ulcer healing after endoscopic submucosal dissection. / Kakushima, Naomi; Fujishiro, Mitsuhiro; Yahagi, Naohisa; Kodashima, Shinya; Nakamura, Masanori; Omata, Masao.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 21, No. 10, 2006, p. 1586-1589.

Research output: Contribution to journalArticle

Kakushima, Naomi ; Fujishiro, Mitsuhiro ; Yahagi, Naohisa ; Kodashima, Shinya ; Nakamura, Masanori ; Omata, Masao. / Helicobacter pylori status and the extent of gastric atrophy do not affect ulcer healing after endoscopic submucosal dissection. In: Journal of Gastroenterology and Hepatology (Australia). 2006 ; Vol. 21, No. 10. pp. 1586-1589.
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AU - Nakamura, Masanori

AU - Omata, Masao

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AB - Background: Eradication therapy for Helicobacter pylori is effective in preventing peptic ulcer recurrence, but its efficacy in ulcer healing is still controversial. The effect of H. pylori on artificial ulcers after endoscopic resection is not known. The purpose of the present study was therefore to evaluate the influence of H. pylori infection on ulcer healing after endoscopic submucosal dissection (ESD). Methods: One hundred and 10 patients who underwent ESD for gastric tumors, and for whom the infection status of H. pylori was confirmed before treatment, were included. The healing stage was studied by endoscopy performed at 8 weeks after ESD. In addition, 73 patients whose serum pepsinogen (PG) was evaluated before ESD, were divided into three groups: PG positive (PGI ≤ 70 ng/mL and I/II ≤ 3 ng/mL), strongly positive (PGI ≤ 30 ng/mL and I/II ≤ 2 ng/mL) and negative, to study the influence of atrophic gastritis on ulcer healing. Results: Ulcer healing was observed in 85 patients (93%) who were H. pylori positive, and in 19 patients (100%) in whom H. pylori had been eradicated previously. Serum PG level had no influence on the healing process. Among 15 patients with ulceration or ulcer scar with the lesion, ulcer healing was observed in nine patients (60%), which was significantly low. Conclusions: Infection status of H. pylori and the extent of gastric atrophy do not affect ulcer healing after ESD. Preoperative existence of fibrotic change in the submucosal layer may delay the healing process.

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