ORAL RABEPRAZOLE ADMINISTRATION ON A PROCEDURE DAY SUPPRESSES BLEEDING AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTRIC NEOPLASMS

TAKUTO HIKICHI; MASAKI SATO; KO WATANABE; JUN NAKAMURA; TADAYUKI TAKAGI; REI SUZUKI; MITSURU SUGIMOTO; YUICHI WARAGAI; HITOMI KIKUCHI; NAOKI KONNO; HIROMASA OHIRA; KATSUTOSHI OBARA

doi:10.5387/fms.2013-17

Original Article

ORAL RABEPRAZOLE ADMINISTRATION ON A PROCEDURE DAY SUPPRESSES BLEEDING AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTRIC NEOPLASMS

TAKUTO HIKICHI, MASAKI SATO, KO WATANABE, JUN NAKAMURA, TADAYUKI TAKAGI, REI SUZUKI, MITSURU SUGIMOTO, YUICHI WARAGAI, HITOMI KIKUCHI, NAOKI KONNO, HIROMASA OHIRA, KATSUTOSHI OBARA

Author information

TAKUTO HIKICHI
Department of Endoscopy, Fukushima Medical University Hospital
MASAKI SATO
Department of Gastroenterology and Rheumatology, Fukushima Medical University
KO WATANABE
Department of Endoscopy, Fukushima Medical University Hospital
JUN NAKAMURA
Department of Gastroenterology and Rheumatology, Fukushima Medical University
TADAYUKI TAKAGI
Department of Gastroenterology and Rheumatology, Fukushima Medical University
REI SUZUKI
Department of Gastroenterology and Rheumatology, Fukushima Medical University
MITSURU SUGIMOTO
Department of Gastroenterology and Rheumatology, Fukushima Medical University
YUICHI WARAGAI
Department of Gastroenterology and Rheumatology, Fukushima Medical University
HITOMI KIKUCHI
Department of Gastroenterology and Rheumatology, Fukushima Medical University
NAOKI KONNO
Department of Gastroenterology and Rheumatology, Fukushima Medical University
HIROMASA OHIRA
Department of Gastroenterology and Rheumatology, Fukushima Medical University
KATSUTOSHI OBARA
Department of Endoscopy, Fukushima Medical University Hospital

Keywords: endoscopic submucosal dissection (ESD), proton pump inhibitor (PPI), gastric pH, oral administration, bleeding, complication

JOURNAL OPEN ACCESS FULL-TEXT HTML

2014 Volume 60 Issue 1 Pages 68-74

DOI https://doi.org/10.5387/fms.2013-17

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Abstract

[Aim] The efficacy of pre-procedure oral proton pump inhibitor (PPI) administration for gastric endoscopic submucosal dissection (ESD) is unclear. This study evaluated oral PPI administration effectiveness on the day of ESD to prevent post-ESD bleeding. [Methods] This study examined 55 patients who underwent ESD for gastric neoplasm. Group A comprised 31 patients who took rabeprazole sodium (RPZ) 20 mg/day beginning 7-8 hr before ESD. Group B comprised 24 who took RPZ 20 mg/day beginning three days before ESD. Gastric pH (G-pH) was measured at one month before ESD (pre-ESD pH), immediately before ESD (ESD pH), and seven days after ESD (post-ESD pH). The post-ESD bleeding rate and changes in G-pH were recorded. [Results] No significant difference in post-ESD bleeding rates was found (Group A 3.2%, Group B 0%). ESD pH and post-ESD pH were significantly higher than pre-ESD pH in both groups (P<0.001). The ESD pH for Group A was higher than 6 (6.5±1.1), providing hemostasis for intragastric bleeding. [Conclusions] Oral RPZ administration on the day of gastric ESD can suppress post-ESD bleeding equivalently to administration three days before ESD.

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