Comparison of efficacy of pharmacological therapies for gastric endoscopic submucosal dissection-induced ulcers: a systematic review and network meta-analysis

Gao, Huiqin; Li, Lunan; Zhang, Chenjing; Tu, Jiangfeng; Geng, Xiaoge; Wang, Jingya; Zhou, Xiaolu; Jing, Jiyong; Pan, Wensheng

doi:10.1080/17474124.2020.1731304

Cited by 6 publications

(5 citation statements)

References 63 publications

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“…Also continuous PPI infusion for 48-72 h after ESD is frequently used, although the benefit of this aggressive acid-suppressive approach has been questioned by RCT findings of similar PPB rates in patients given intravenous bolus PPI [87,105], oral PPI [106], and even placebo [107] (Table 3 s). Vonoprazan, a potassium-competitive acid-blocker (P-CAB), approved in Japan, has also been evaluated in this setting, but several meta-analyses did not show superiority of this therapy in reducing PPB when compared with PPI, although P-CABs have shown some advantages in ulcer healing speed [108][109][110][111][112]. Regarding preprocedural PPI administration, there is no evidence of benefit in preventing PPB although there are potential advantages in reducing IPB [113].…”

Section: Stomachmentioning

confidence: 99%

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Libânio

Pimentel‐Nunes

Bastiaansen³

et al. 2023

Endoscopy

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ESGE suggests conventional endoscopic submucosal dissection (ESD; marking and mucosal incision followed by circumferential incision and stepwise submucosal dissection) for most esophageal and gastric lesions. ESGE suggests tunneling ESD for esophageal lesions involving more than two-thirds of the esophageal circumference. ESGE recommends the pocket-creation method for colorectal ESD, at least if traction devices are not used. The use of dedicated ESD knives with size adequate to the location/thickness of the gastrointestinal wall is recommended. It is suggested that isotonic saline or viscous solutions can be used for submucosal injection. ESGE recommends traction methods in esophageal and colorectal ESD and in selected gastric lesions. After gastric ESD, coagulation of visible vessels is recommended, and post-procedural high dose proton pump inhibitor (PPI) (or vonoprazan). ESGE recommends against routine closure of the ESD defect, except in duodenal ESD. ESGE recommends corticosteroids after resection of > 50 % of the esophageal circumference. The use of carbon dioxide when performing ESD is recommended. ESGE recommends against the performance of second-look endoscopy after ESD. ESGE recommends endoscopy/colonoscopy in the case of significant bleeding (hemodynamic instability, drop in hemoglobin > 2 g/dL, severe ongoing bleeding) to perform endoscopic hemostasis with thermal methods or clipping; hemostatic powders represent rescue therapies. ESGE recommends closure of immediate perforations with clips (through-the-scope or cap-mounted, depending on the size and shape of the perforation), as soon as possible but ideally after securing a good plane for further dissection.

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Section: Stomachmentioning

confidence: 99%

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Libânio

Pimentel‐Nunes

Bastiaansen³

et al. 2023

Endoscopy

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“…Association between Helicobacter pylori infection and dyslipidemia has been reported significantly [ 35 ]. Gastric ulcer is a chronic disease of high worldwide prevalence, associated to unexpected complications such as bleeding, perforation, and stenosis [ 36 ]. The imbalances of gastric mucosal defense mechanisms (prostaglandins, mucus, mucosal blood flow, bicarbonate, nitric oxide, and sulfhydryl compounds, and ATP sensitive K + channels) against exposure to endogenous and exogenous factors (e.g., non-steroidal anti-inflammatory drugs (NSAIDs), pepsin, bile acids, alcohol, stress, and trauma, Helicobacter pylori infection, hemorrhagic shock, sepsis, and burns) promote the development of gastric ulcers [ 36 , 37 ].…”

Section: Introductionmentioning

confidence: 99%

Red Propolis and Its Dyslipidemic Regulator Formononetin: Evaluation of Antioxidant Activity and Gastroprotective Effects in Rat Model of Gastric Ulcer

et al. 2020

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Propolis has various pharmacological properties of clinical interest, and is also considered a functional food. In particular, hydroalcoholic extracts of red propolis (HERP), together with its isoflavonoid formononetin, have recognized antioxidant and anti-inflammatory properties, with known added value against dyslipidemia. In this study, we report the gastroprotective effects of HERP (50–500 mg/kg, p.o.) and formononetin (10 mg/kg, p.o.) in ethanol and non-steroidal anti-inflammatory drug-induced models of rat ulcer. The volume, pH, and total acidity were the evaluated gastric secretion parameters using the pylorus ligature model, together with the assessment of gastric mucus contents. The anti-Helicobacter pylori activities of HERP were evaluated using the agar-well diffusion method. In our experiments, HERP (250 and 500 mg/kg) and formononetin (10 mg/kg) reduced (p < 0.001) total lesion areas in the ethanol-induced rat ulcer model, and reduced (p < 0.05) ulcer indices in the indomethacin-induced rat ulcer model. Administration of HERP and formononetin to pylorus ligature models significantly decreased (p < 0.01) gastric secretion volumes and increased (p < 0.05) mucus production. We have also shown the antioxidant and anti-Helicobacter pylori activities of HERP. The obtained results indicate that HERP and formononetin are gastroprotective in acute ulcer models, suggesting a prominent role of formononetin in the effects of HERP.

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“…Intermittent vomiting was observed in 5 (6.8%) and 1 (1.7%) patients, respectively. By day 7, pain symptoms persisted in 12.3% (9) in the comparison group and in 3.4% (2) in the main group (Table 2). Control endoscopy on days 7-8 due to the development of a clinically significant anastomositis was performed in 37 patients in the comparison group and only 8 patients in the main group (Fig.…”

Section: Methodsmentioning

confidence: 97%

“…Factors associated with pathology include pathological features (size and location of the ulcer, presence of perforation, local tissue inflammation, suspected malignant neoplasm, peritonitis and sepsis) [4,9]. Patient-related factors include age, gender, and comorbidities, while health-related factors include the availability of medical facilities and a trained surgeon [1].…”

Section: Introductionmentioning

confidence: 99%

Prevention of The Development of Postoperative Complications and Their Treatment in The Surgery of Duedenal Purpose

Khojimetov¹

2021

ijmra

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The authors analyze various degrees of physiological anastomositis in 131 patients, and conclude that for the treatment of late anastomositis after surgical interventions on the stomach and duodenum, it is recommended to include the laser action of the anastomosis zone with two types of low-energy lasers in the complex program. The authors argue that the combined use of low-energy laser exposure through endoscopic and percutaneous irradiation will improve the effectiveness of the treatment of late anastomositis.

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Comparison of efficacy of pharmacological therapies for gastric endoscopic submucosal dissection-induced ulcers: a systematic review and network meta-analysis

Cited by 6 publications

References 63 publications

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Endoscopic submucosal dissection techniques and technology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review

Red Propolis and Its Dyslipidemic Regulator Formononetin: Evaluation of Antioxidant Activity and Gastroprotective Effects in Rat Model of Gastric Ulcer

Prevention of The Development of Postoperative Complications and Their Treatment in The Surgery of Duedenal Purpose

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