PMID- 26165736
OWN - NLM
STAT- MEDLINE
DCOM- 20160922
LR  - 20170502
IS  - 1438-8812 (Electronic)
IS  - 0013-726X (Linking)
VI  - 47
IP  - 12
DP  - 2015 Dec
TI  - Factors influencing development of pain after gastric endoscopic submucosal 
      dissection: a randomized controlled trial.
PG  - 1119-23
LID - 10.1055/s-0034-1392537 [doi]
AB  - BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) is widely used 
      for local treatment of gastric neoplasms. Although ESD-related complications such 
      as bleeding and perforation have been reported, data are currently lacking on the 
      development of pain, which is one of the most common adverse events after ESD. 
      The aim of the current study was to investigate the incidence and 
      clinicopathologic risk factors of pain after ESD. PATIENTS AND METHODS: A 
      prospective randomized controlled study was conducted to evaluate 156 patients 
      with gastric neoplasms treated by ESD at Gangnam Severance Hospital between April 
      2011 and August 2013. All patients were randomly assigned to treatment with 
      intravenous proton pump inhibitor (PPI) either before or after ESD. Acid infusion 
      tests were performed in a subgroup of 21 patients to investigate the mechanism of 
      pain after ESD. RESULTS: The incidence of moderate-to-severe pain after ESD was 
      significantly lower in the group that received preprocedure PPI (44.9%) compared 
      to those who did not (62.8%). Female sex, tumors of the distal stomach (I.e. 
      lower third), baseline dyspeptic symptoms, and positive acid infusion testing 
      were variables that correlated significantly with the development of pain after 
      ESD, although female sex was not significant in multivariate analysis. 
      CONCLUSIONS: Patients with tumors of the distal stomach and baseline dyspeptic 
      symptoms were more likely to develop pain after gastric ESD. Hypersensitivity to 
      acid was one mechanism fueling post-ESD pain. Prophylactic PPI treatment was 
      effective at reducing post-ESD pain.Trial registered at Clinicaltrials.gov 
      (NCT02254889).
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Jung, Da Hyun
AU  - Jung DH
AD  - Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University 
      College of Medicine, Seoul, Korea.
FAU - Youn, Young Hoon
AU  - Youn YH
AD  - Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University 
      College of Medicine, Seoul, Korea.
FAU - Kim, Jie-Hyun
AU  - Kim JH
AD  - Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University 
      College of Medicine, Seoul, Korea.
FAU - Park, Hyojin
AU  - Park H
AD  - Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University 
      College of Medicine, Seoul, Korea.
LA  - eng
SI  - ClinicalTrials.gov/NCT02254889
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20150710
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - Endoscopy. 2015 Dec;47(12):1197. PMID: 26630341
MH  - Aged
MH  - *Dissection/adverse effects/methods
MH  - Drug Monitoring/methods
MH  - Female
MH  - *Gastroscopy/adverse effects/methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Management/methods
MH  - Pain Measurement/methods
MH  - *Pain, Postoperative/diagnosis/prevention & control
MH  - Perioperative Care/methods
MH  - Proton Pump Inhibitors/*administration & dosage
MH  - *Stomach/pathology/surgery
MH  - *Stomach Neoplasms/pathology/surgery
MH  - Treatment Outcome
EDAT- 2015/07/15 06:00
MHDA- 2016/09/23 06:00
CRDT- 2015/07/14 06:00
PHST- 2015/07/14 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2016/09/23 06:00 [medline]
AID - 10.1055/s-0034-1392537 [doi]
PST - ppublish
SO  - Endoscopy. 2015 Dec;47(12):1119-23. doi: 10.1055/s-0034-1392537. Epub 2015 Jul 
      10.