Journal of Gastroenterology

, Volume 46, Issue 11, pp 1267–1272

Effect of lansoprazole versus roxatidine on prevention of bleeding and promotion of ulcer healing after endoscopic submucosal dissection for superficial gastric neoplasia

Authors

    • Department of General Internal MedicineSaitama Medical University
    • Center for Diagnostic and Therapeutic Endoscopy, School of MedicineKeio University
  • Naoki Hosoe
    • Center for Diagnostic and Therapeutic Endoscopy, School of MedicineKeio University
  • Hidekazu Suzuki
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of MedicineKeio University
  • Yoshimasa Saito
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of MedicineKeio University
  • Yosuke Ida
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of MedicineKeio University
  • Rieko Nakamura
    • Center for Diagnostic and Therapeutic Endoscopy, School of MedicineKeio University
  • Yasushi Iwao
    • Center for Diagnostic and Therapeutic Endoscopy, School of MedicineKeio University
  • Haruhiko Ogata
    • Center for Diagnostic and Therapeutic Endoscopy, School of MedicineKeio University
  • Toshifumi Hibi
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of MedicineKeio University
Original Article—Alimentary Tract

DOI: 10.1007/s00535-011-0447-1

Cite this article as:
Imaeda, H., Hosoe, N., Suzuki, H. et al. J Gastroenterol (2011) 46: 1267. doi:10.1007/s00535-011-0447-1

Abstract

Background

Proton pump inhibitors have been reported to be more useful than histamine-2 receptor antagonists for the prevention of bleeding after endoscopic submucosal dissection (ESD) for superficial gastric neoplasia. The aim of this study was to assess the effects of the proton pump inhibitor lansoprazole and the histamine-2 receptor antagonist roxatidine for the prevention of bleeding and the promotion of ulcer healing after ESD and to compare the cost-effectiveness of these two drugs.

Methods

The study subjects were 129 patients who underwent ESD for superficial gastric neoplasia. The patients were randomly assigned to the lansoprazole group (L group) or the roxatidine group (R group). Either drug was administered intravenously from the morning of the ESD day to the day after the ESD, followed by oral treatment for an additional 8 weeks. A second-look endoscopy was performed on the day after the ESD, and a repeat endoscopy was performed at 8 weeks after the ESD. The incidence of bleeding and the ulcer-healing rate at 8 weeks after the ESD were analyzed, as well as the total cost of treatment with these antisecretory agents.

Results

Three patients in each group were excluded from the analysis, leaving 62 patients in L group and 61 in R group. Two of the 62 patients (3.2%) in L group and three of the 61 patients (4.9%) in R group showed bleeding after ESD ; there was no significant difference between the two groups (P = 0.68). The ulcer-healing rate was 93.5% (58/62) in L group and 93.4% (57/61) in R group (P = 1). The total cost of treatment with the antisecretory agent from the day of the ESD to day 56 after the ESD was Yen 13,212 for lansoprazole and Yen 5,841 for roxatidine.

Conclusions

Roxatidine appears to have high cost-effectiveness in the prevention of bleeding and in the promotion of ulcer healing after ESD for superficial gastric neoplasia.

Keywords

Bleeding Ulcer healing Endoscopic submucosal dissection Gastric neoplasia Roxatidine Lansoprazole H2-receptor antagonist Proton pump inhibitor

Copyright information

© Springer 2011