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. 2019 May;98(22):e15807.
doi: 10.1097/MD.0000000000015807.

The effect of early Helicobacter pylori eradication on the healing of ESD-induced artificial ulcers: A retrospective study

Wen Chong Song  1 , Xiao Feng Wang, Wei Wei Lv, Xiao Yan Xu, De Min Tian
Affiliations

The effect of early Helicobacter pylori eradication on the healing of ESD-induced artificial ulcers: A retrospective study

Wen Chong Song et al. Medicine (Baltimore). 2019 May.

Abstract

Background: The role of Helicobacter pylori eradication is still not clear in endoscopic submucosal dissection (ESD)-induced artificial ulcer. This study investigates the therapeutic effects of H. pylori eradication on ESD-induced artificial ulcers.

Methods: Eighty-four patients with ESD-induced artificial ulcers were enrolled. H. pylori eradication success subgroup (Group A1) and H. pylori eradication failure subgroups (Group A2) received standard triple therapy orally for 7 days, followed by esomeprazole 20 mg bis in die (bid) orally for the remainder of the treatment period (4 weeks in total). The H. pylori positive (Group B1) and H. pylori negative subgroups (Group B2) received esomeprazole 20 mg bid orally for 4 weeks. Ulcer healing was evaluated by gastroscopy, and H. pylori was identified by a C13 breath test or an Hp-RUT 2 and 6 months after treatment.

Results: Successful eradication of H. pylori can promote healing of ESD-induced artificial ulcers. The ESD-induced artificial ulcer healing rate in Group A1 was statistically higher than that in Groups A2, B1, and B2.

Conclusion: Our results indicated that early H. pylori eradication therapy can promote ESD-induced artificial ulcer healing in H. pylori positive patients with ESD-induced artificial ulcers.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
The F-figure for ulcer staging ratio of 2 months after ESD in Groups A, B. There was not statistically significant difference in ulcer stage between Group A and Group B (P > .05).
Figure 2
Figure 2
The F-figure for ulcer staging ratio of 6 months after ESD in Groups A, B. Only 4.08% were in stage H2 and 95.92% were in stage S1 or S2 in Group A; however, in Group B, 0.82% were in stage H1, 7.38% were in stage H2, and 91.74% were in stage S1 or S2. Therefore, there was significant difference between the 2 group (P = .022).
Figure 3
Figure 3
The F-figure for ulcer staging ratio of 2 months after ESD in Groups A1, A2, B1, B2. There was significant difference in ulcer stage between Group A1 and Group A2 [stage H1: 1 vs 3 case (3.13% vs 17.65%), stage H2: 3 vs 4 case (9.38% vs 23.53%)] (P < .05), but there was a statistically significant difference in the stage S2 between Group A1 and Group A2 (P < .05). In Groups B1 and B2, it still had few patients in stage A1 (4.08%, 1.37%), A2 (2.04%, 4.11%). But Group A1 and Group A2 did not have patients in stage A. Group A1 had better stages than Group A2 (P = .036), Groups B1 (P = .046), and B2 (P = .039).
Figure 4
Figure 4
The F-figure for ulcer staging ratio of 6 months after ESD in Groups A1, A2, B1, B2. About 11.76% were in stage H2 and the others were in stage S1 (23.53%) or S2 (64.71%) in Group A2, but all patients in Group A1 were in stage S1 (8.38%) or S2 (91.62%). In Group B1, 2.04% were in stage H1, 4.08% were in stage H2, 28.57% were in stage S1, and 63.27% were in stage S2. In Group B2, 9.59% were in stage H2, 30.14% were in stage S1, and 60.27% were in stage S2. Group A1 had better stages than Group A2, Groups B1, and B2 (P = .024).
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