Background Although EMR-induced ulcers heal faster and recur less often than noniatrogenic gastric ulcers, there is no consensus regarding the duration of therapy for these ulcers.This study prospectively evaluated he...Background Although EMR-induced ulcers heal faster and recur less often than noniatrogenic gastric ulcers, there is no consensus regarding the duration of therapy for these ulcers.This study prospectively evaluated healing of EMR-induced ulcers according to the duration of omeprazole therapy. Methods A total of 69 patients were randomly assigned, after EMR,to treatment with omeprazole (20 mg per day) for 7 days (1-week group) or with omeprazole (20 mg per day) for 28 days(4-week group). Four weeks after EMR, ulcer size and stage were compared with those of the initial EMR-induced ulcer.Each patient kept a daily diary of drugs consumed and ulcer related symptoms during the 4-week period after EMR. Results Thirty-four patients were randomized to the 4-week group, and 26 were randomized to the 1-week group. No significant differences were observed between the two groups at 4 weeks after EMR in terms of ulcer reduction ratio (p=0.29) or stage(p=0.11). In addition, no difference was observed between the two groups with respect to ulcer-related symptoms or use of additional gastric-coating medication (p=0.48). Conclusions For EMR-induced ulcer, treatment with omeprazole for 1 week is equivalent to treatment for 4 weeks. Short-term therapy with omeprazole can be consi dered for EMR-induced ulcer. patients with 64 small upper-GI leiomyomas arising in the muscularis propria as determined by endoscopy, EUS, and EUS-guided FNA. The distribution of the 64 leiomyomas was the following: esophageal, 50; gastric, 12; duodenal, 2. A standard endoscope with a transparent cap attached to the tip was used. The cap was placed over the lesion, maximum sustained suction was applied, and an elastic band was released around the base. Beginning 2 weeks after banding,the lesions were observed endoscopically once per week until healing was complete. Results: The 50 esophageal leiomyomas sloughed completely. The mean time required for complete healing after band ligation was 3.6 weeks. Nine of the 12 gastric leiomyomas sloughed completely; the resulting ulcer defect was healed at a mean of 4.5 weeks.The other 3 lesions did not slough because they were not completely ligated. The two duodenal lesions sloughed completely after banding, and the mean time until healing of the defect was 4.5 weeks. No perforation occurred. Follow-up ranged from 16 to 31 months, during which time no recurrence was observed. Conclusions: Endoscopic band ligation is an effective and safe treatment for small upper-GIleiomyoma.展开更多
文摘Background Although EMR-induced ulcers heal faster and recur less often than noniatrogenic gastric ulcers, there is no consensus regarding the duration of therapy for these ulcers.This study prospectively evaluated healing of EMR-induced ulcers according to the duration of omeprazole therapy. Methods A total of 69 patients were randomly assigned, after EMR,to treatment with omeprazole (20 mg per day) for 7 days (1-week group) or with omeprazole (20 mg per day) for 28 days(4-week group). Four weeks after EMR, ulcer size and stage were compared with those of the initial EMR-induced ulcer.Each patient kept a daily diary of drugs consumed and ulcer related symptoms during the 4-week period after EMR. Results Thirty-four patients were randomized to the 4-week group, and 26 were randomized to the 1-week group. No significant differences were observed between the two groups at 4 weeks after EMR in terms of ulcer reduction ratio (p=0.29) or stage(p=0.11). In addition, no difference was observed between the two groups with respect to ulcer-related symptoms or use of additional gastric-coating medication (p=0.48). Conclusions For EMR-induced ulcer, treatment with omeprazole for 1 week is equivalent to treatment for 4 weeks. Short-term therapy with omeprazole can be consi dered for EMR-induced ulcer. patients with 64 small upper-GI leiomyomas arising in the muscularis propria as determined by endoscopy, EUS, and EUS-guided FNA. The distribution of the 64 leiomyomas was the following: esophageal, 50; gastric, 12; duodenal, 2. A standard endoscope with a transparent cap attached to the tip was used. The cap was placed over the lesion, maximum sustained suction was applied, and an elastic band was released around the base. Beginning 2 weeks after banding,the lesions were observed endoscopically once per week until healing was complete. Results: The 50 esophageal leiomyomas sloughed completely. The mean time required for complete healing after band ligation was 3.6 weeks. Nine of the 12 gastric leiomyomas sloughed completely; the resulting ulcer defect was healed at a mean of 4.5 weeks.The other 3 lesions did not slough because they were not completely ligated. The two duodenal lesions sloughed completely after banding, and the mean time until healing of the defect was 4.5 weeks. No perforation occurred. Follow-up ranged from 16 to 31 months, during which time no recurrence was observed. Conclusions: Endoscopic band ligation is an effective and safe treatment for small upper-GIleiomyoma.
