SUMMARYBackground: The resistance of Helicobacter pylori to clarithromycin has become one of the primary reasons for eradication failure. Aim: To compare the eradication rates of triple therapy using amoxicillin (A), clarithromycin (C) and rabeprazole (R) or lansoprazole (L) against clarithromycinsensitive and clarithromycin-resistant strains. Methods: Two hundred and ninety-five patients were randomly divided into four groups and treated for 1 week: 147 cases were treated with RAC, i.e. 49 cases with R20C400 (10 mg R + 750 mg A + 200 mg C, twice daily), 48 cases with R40C400 (20 mg R + 750 mg A + 200 mg C, twice daily) and 50 cases with R40C800 (20 mg R + 750 mg A + 400 mg C, twice daily); 148 cases with treated with LAC (30 mg L + 750 mg A + 200 mg C, twice daily).
A combination of rabeprazole, minocycline, and metronidazole is safe and effective for second-line therapy of H. pylori infection. Because this regimen can be administered to patients with penicillin allergy and patients who suffer adverse reactions to amoxicillin, such as diarrhea and other digestive symptoms, it should be considered useful for second- and third-line eradication therapy.
Severe endoscopical atrophy, OLGA staging, histological atrophy at the antrum, inflammation, and particularly IM at the corpus, were identified as risk factors for gastric cancer development following H. pylori eradication. Therefore, eradication should be performed before these predictors develop.
Little is known about the outcomes of laparoscopic wedge resection (LWR) in comparison with conventional open wedge resection (OWR) for gastric submucosal tumor. Outcomes of 21 patients who underwent LWR (n = 14) or OWR (n = 7) for gastric submucosal tumor between 1993 and 2004 were investigated. We compared the short-term and long-term operative results between the 2 groups. LWR showed several advantages over OWR for gastric submucosal tumor: less blood loss, lower fever on day 1, lower analgesic usage rate, earlier first postoperative flatus and oral intake, lower leukocyte count on days 1 and 7, and lower C-reactive protein level on days 1 and 3. All patients, except 2 with histologically diagnosed high-risk gastrointestinal stromal tumor, survived during the mean follow-up period of 60 months. LWR is feasible for the management of patients with gastric submucosal tumor.
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