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There is no consensus on the best perioperative strategy for patients undergoing endoscopic submucosal dissection (ESD)
.
Recently, a single-center prospective, randomized, double-blind, placebo-controlled trial investigated the effect of intravenous proton pump inhibitor (PPI) during fasting after ESD on delayed bleeding after ESD.
consensus
From March 2016 to September 2018, the study included 235 patients receiving ESD treatment for adenomas and early stagePatients with gastric cancer were randomly divided into PPI group and placebo group
.
During the 48-hour fasting period after ESD (from the day of ESD to the next day, 48 hours), the patients received intravenous injection of pantoprazole 40 mg (PPI group) or placebo (placebo group) every day
Stomach cancer
The results showed that among 235 patients with intention to treat (ITT) and 195 patients analyzed by protocol (PP), the PPI group and the control group had major bleeding after ESD (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)
.
There were no significant differences between the two groups in terms of age (p = 0.
In summary, the results of this study indicate that routine intravenous injection of PPI during the 48-hour fasting period after ESD does not reduce delayed bleeding after ESD
Original source:
Jai Hoon Yoon, et al.
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 in this message
