Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2017; 9(10): 514-520
Published online Oct 16, 2017. doi: 10.4253/wjge.v9.i10.514
Oral esomeprazole vs injectable omeprazole for the prevention of hemorrhage after endoscopic submucosal dissection
Takashi Uchiyama, Takuma Higurashi, Hitoshi Kuriyama, Yoshinobu Kondo, Yasuo Hata, Atsushi Nakajima
Takashi Uchiyama, Takuma Higurashi, Atsushi Nakajima, Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama city, Kanagawa Prefecture 236-0042, Japan
Takashi Uchiyama, Hitoshi Kuriyama, Yasuo Hata, Department of Gastroenterology, Chigasaki Municipal Hospital, Chigasaki city, Kanagawa Prefecture 235-0042, Japan
Yoshinobu Kondo, Department of Endocrinology and Metabolism, Chigasaki Municipal Hospital, Chigasaki city, Kanagawa Prefecture 235-0042, Japan
Author contributions: Uchiyama T collected and analyzed the data, and drafted the manuscript; Higurashi T provided analytical oversight; Nakajima A supervised the study; Kuriyama H and Hata Y revised the manuscript for important intellectual content; Kondo Y offered the technical support; authors have read and approved the final version to be published.
Institutional review board statement: Ethics committee approval was received for this study from the ethics committee of Chigasaki Municipal Hospital.
Informed consent statement: All the treatment procedures were performed after obtaining informed consent in writing from the patients.
Conflict-of-interest statement: No conflict of interest was declared by the authors.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takashi Uchiyama, MD, PhD, Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawaku, Yokohama city, Kanagawa 236-0004, Japan. tuchiyama-ykh@umin.ac.jp
Telephone: +81-45-7872640 Fax: +81-45-7843546
Received: March 22, 2017
Peer-review started: March 23, 2017
First decision: April 17, 2017
Revised: May 19, 2017
Accepted: July 14, 2017
Article in press: July 17, 2017
Published online: October 16, 2017
Abstract
AIM

To evaluate the effectiveness of oral esomeprazole (EPZ) vs injectable omeprazole (OPZ) therapy to prevent hemorrhage after endoscopic submucosal dissection (ESD).

METHODS

A case-control study was conducted using a quasi-randomized analysis with propensity score matching. A total of 258 patients were enrolled in this study. Patients were treated with either oral EPZ or injectable OPZ. The endpoint was the incidence of hemorrhage after ESD.

RESULTS

Data of 71 subjects treated with oral EPZ and 172 subjects treated with injectable OPZ were analyzed. Analysis of 65 matched samples revealed no difference in the incidence of hemorrhage after ESD between the oral EPZ and injectable OPZ groups (OR = 0.89, 95%CI: 0.35-2.27, P ≥ 0.99).

CONCLUSION

We conclude that oral EPZ therapy is a useful alternative to injectable PPI therapy for the prevention of hemorrhage after ESD.

Keywords: Endoscopic submucosal dissection, Proton pump inhibitors, Hemorrhage

Core tip: Proton pump inhibitors (PPIs) have been reported to be effective for suppressing hemorrhage after endoscopic submucosal dissection (ESD); however, it remains unclear whether oral PPI therapy or injectable PPI therapy is preferable. The results of the present study indicate that oral effectiveness of oral esomeprazole therapy is a useful alternative to injectable PPI therapy for the prevention of hemorrhage after ESD.