PMID- 31845139
OWN - NLM
STAT- MEDLINE
DCOM- 20210414
LR  - 20240213
IS  - 1873-4626 (Electronic)
IS  - 1091-255X (Linking)
VI  - 24
IP  - 11
DP  - 2020 Nov
TI  - Effect on Bleeding Prevention of an Intravenous Proton Pump Inhibitor During the 
      Fasting Period After Endoscopic Submucosal Dissection: a Prospective, Randomized, 
      Double-Blind, Placebo-Controlled Trial.
PG  - 2596-2601
LID - 10.1007/s11605-019-04466-9 [doi]
AB  - BACKGROUND: No consensus has been achieved on optimal perioperative strategies 
      for patients undergoing endoscopic submucosal dissection (ESD). The aim of this 
      study was to investigate the effects of an intravenous (IV) proton pump inhibitor 
      (PPI) given during the fasting period after ESD on delayed bleeding following 
      ESD. METHODS: This study was designed as a prospective, randomized, double-blind, 
      placebo-controlled trial in a single center. A total of 235 patients who 
      underwent ESD for adenoma and early gastric cancer between March 2016 and 
      September 2018 were randomized into a PPI group and placebo group. Patients were 
      administrated intravenous pantoprazole 40 mg daily (PPI group) or placebo 
      (placebo group) during the fasting period 48 h after ESD (from the day of ESD to 
      the following day, 48 h). After oral feeding (48 h after ESD), oral PPI was given 
      to both groups for 8 weeks. RESULTS: Among 235 patients in the intention-to-treat 
      (ITT) and 195 in the per-protocol (PP) analysis, there was no significant 
      difference between the PPI and control groups in major bleeding (PPI vs. placebo; 
      3.3% vs. 1.7%, p = 0.27) or minor bleeding (PPI vs. placebo; 7.6% vs. 4.3%, p = 
      0.41) after ESD. There was no significant difference in age (p = 0.28), histology 
      (p = 0.75), tumor size (p = 0.48), or procedure time (p = 0.49) between the two 
      groups. The only independent risk factor for major delayed bleeding was the 
      combined use of aspirin and antiplatelet agent (OR; 12.25, 95% CI; 1.06-141.19, p 
      = 0.04). CONCLUSIONS: Administration of routine IV PPI during the fasting period 
      48 h after ESD does not reduce delayed post-ESD bleeding.
FAU - Yoon, Jai Hoon
AU  - Yoon JH
AD  - Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 
      South Korea.
FAU - Kim, Youn Jeong
AU  - Kim YJ
AD  - Division of Infectious disease, Department of Internal medicine, College of 
      Medicine, The Catholic University of Korea, Seoul, South Korea.
FAU - Lee, Kang Nyeong
AU  - Lee KN
AD  - Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 
      South Korea.
FAU - Jun, Dae Won
AU  - Jun DW
AD  - Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 
      South Korea.
FAU - Koh, Dong Hee
AU  - Koh DH
AD  - Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, 
      Hwaseong-si, South Korea.
FAU - Lee, Hang Lak
AU  - Lee HL
AD  - Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 
      South Korea. alwayshang@hanyang.ac.kr.
AD  - Department of Gastroenterology, Hanyang University Hospital, Sungdonggu 
      Hangdangdong 17, Seoul, 133-070, South Korea. alwayshang@hanyang.ac.kr.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20191216
PL  - Netherlands
TA  - J Gastrointest Surg
JT  - Journal of gastrointestinal surgery : official journal of the Society for Surgery 
      of the Alimentary Tract
JID - 9706084
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - *Anti-Ulcer Agents/therapeutic use
MH  - *Endoscopic Mucosal Resection/adverse effects
MH  - Fasting
MH  - Gastroscopy
MH  - Humans
MH  - Prospective Studies
MH  - Proton Pump Inhibitors
MH  - *Stomach Neoplasms/drug therapy/surgery
OTO - NOTNLM
OT  - Bleeding
OT  - Endoscopic submucosal dissection
OT  - Proton pump inhibitor
EDAT- 2019/12/18 06:00
MHDA- 2021/04/15 06:00
CRDT- 2019/12/18 06:00
PHST- 2019/04/28 00:00 [received]
PHST- 2019/11/06 00:00 [accepted]
PHST- 2019/12/18 06:00 [pubmed]
PHST- 2021/04/15 06:00 [medline]
PHST- 2019/12/18 06:00 [entrez]
AID - S1091-255X(23)01846-2 [pii]
AID - 10.1007/s11605-019-04466-9 [doi]
PST - ppublish
SO  - J Gastrointest Surg. 2020 Nov;24(11):2596-2601. doi: 10.1007/s11605-019-04466-9. 
      Epub 2019 Dec 16.