ESOMEPRAZOLE VS RABEPRAZOLE IN THE HEALING OF ARTIFICIAL ULCERS AFTER THE ENDOSCOPIC SUBMUCOSAL DISSECTION USING THE CLUTCH CUTTER: A PROSPECTIVE RANDOMIZED CONTROLLED STUDY

Aims:

Clinical course of post-endoscopic submucosal dissection (ESD) gastric ulcer (PESDGU) is affected by ESD method including kinds of devices and endoscopist's skill. There were no previous reports on the efficacy of proton pump inhibitors for PESDGU healing in patients who underwent single device ESD method by single endoscopist. This prospective randomized controlled study compared the efficacy and safety of esomeprazole (EM) with rabeprazole (RB) in PESDGU healing in the patients who underwent single device ESD method by single endoscopist.

Methods:

Patients who underwent ESD using the Clutch Cutter (ESDCC) only by single well trained endoscopist were randomly assigned to either the EM 20 mg monotherapy or RB 20 mg monotherapy. Fifty-two consecutive patients with gastric tumors gave informed consent for enrolling in the study. After ESD, all patients were treated with intravenous omeprazole for the first 2 day. Oral administration of the drug was then started and continued to the 8^th week. Occurrence of ESD related complications was monitored. Ulcer stage was evaluated 8 week later.

Results:

All patients received the assigned pharmaceuticals and adhered well to the treatment regimen for 8 weeks. There was no Post ESDCC perforation in two group. Post ESDCC bleeding occurred only in 1/25 (4%) patient in the RB group. The endpoint 8^th week ulcers reached scar stage in 26/27 (96%) patients in the EM group and in 19/25 (76%) in the RB group. There was no significant difference between two group.

Conclusions:

EM and RB have equivalent therapeutic effects on PESDGUs.