Proper muscle layer damage affects ulcer healing after gastric endoscopic submucosal dissection

Autor:	Yohei, Horikawa, Nobuya, Mimori, Hiroya, Mizutamari, Yuhei, Kato, Kazuhiro, Shimazu, Masayuki, Sawaguchi, Shin, Tawaraya, Kimihiro, Igarashi, Syunji, Okubo
Rok vydání:	2015
Předmět:	Male Wound Healing Time Factors Dissection Pilot Projects Narrow Band Imaging Postoperative Complications Treatment Outcome Surgery Computer-Assisted Gastric Mucosa Stomach Neoplasms Gastroscopy Humans Female Stomach Ulcer Aged Follow-Up Studies Retrospective Studies
Zdroj:	Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society. 27(7)
ISSN:	1443-1661
Popis:	Endoscopic submucosal dissection (ESD) is the established therapy for superficial gastrointestinal neoplasms. However, management of the artificial ulcers associated with ESD has become important and the relationship between ulcer healing factors and treatment is still unclear. We aimed to evaluate ESD-related artificial ulcer reduction ratio at 4 weeks to assess factors associating with ulcer healing after ESD that may lead to optimal treatment.Between January 2009 and December 2013, a total of 375 lesions fulfilled the expanded criteria for ESD. We defined ulcer reduction rate90% as (A) poor-healing group; and rate ≥90% as (B) well-healing group. After exclusion, 328 lesions were divided into two groups and analyzed. These two groups were compared based on clinicopathological/endoscopic features, concomitant drugs, and treatment.Ulcer reduction rate was significantly correlated with factors related to the ESD procedure (i.e. procedure time, submucosal fibrosis, and injury of the proper muscle layer, in univariate analysis. Multivariate logistic regression analysis showed that submucosal fibrosis (F2) (P = 0.03; OR, 16.46; 95% CI, 1.31-206.73) and injury of the proper muscle layer (P = 0.01; OR, 4.27; 95% CI, 2.04-8.92) were statistically significant predictors of delayed healing.This single-center retrospective study indicated that ESD-induced artificial ulcer healing was affected by submucosal fibrosis and injury of the proper muscle layer, which induced damage to the muscle layer. Therefore, the preferable pharmacotherapy can be determined on completion of the ESD procedure.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::90d3b250b68ff9080f12a9c02aef6feb https://pubmed.ncbi.nlm.nih.gov/26043759 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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