Effect of Helicobacter pylori Eradication on Healing of Iatrogenic Ulcer and Underlying Histology after Endoscopic Submucosal Dissection for Gastric Adenoma and Early Gastric Cancer |
조기 위암과 위 선종에 대한 내시경하 점막하 박리술 후 헬리코박터 파이로리 제균 치료가 의인성 궤양 및 기저 위염에 미치는 효과 |
조수정·김상균·임종필·김주성·정현채·송인채 |
서울대학교 의과대학 내과학교실, 간연구소 |
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Abstract |
Background/Aims: A role of Helicobacter pylori (H. pylori) in the iatrogenic ulcer healing after endoscopic resection for gastric tumors is not clear. This study was conducted to elucidate the effect of H. pylori eradication on the healing of iatrogenic ulcer and underlying histology after endoscopic resection. Methods: A total of 112 patients were prospectively enrolled after endoscopic submucosal dissection (ESD) between April 2005 and September 2006 and randomly assigned to either H. pylori eradication or follow-up group. Follow-up endoscopy was performed at 12 weeks after ESD to evaluate ulcer healing and histological change. Results: H. pylori was eradicated in 45 patients, not eradicated in 63, respectively. The two groups were balanced statistically with respect to sex, age, ulcer size and complication rate. Follow-up endoscopy has revealed that all of the cases healed up to scar stages. Scores of neutrophil (p<0.001) and mononuclear cell infiltration (p=0.048) improved in H. pylori eradicated group. However, atrophy (p=0.656) and intestinal metaplasia (p=0.752) showed no significant differences. Conclusions: H. pylori eradication did not influence on ESD-induced iatrogenic ulcer healing as well as underlying atrophy or intestinal metaplasia. Long-term follow-up is warranted whether H. pylori eradication could reduce the risk of metachronous tumor development. (The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2007;7:26-32) |
Key Words:
Helicobacter pylori, Endoscopic submucosal dissection, Eradication, Ulcer healing, Gastric histology |
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