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Preventing metachronous gastric lesions after endoscopic submucosal dissection through Helicobacter pylori eradication

 Sungmo Jung  ;  Chan Hyuk Park  ;  Eun Hye Kim  ;  Su Ji Shin  ;  Hyunsoo Chung  ;  Hyuk Lee  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Yong Chan Lee  ;  Sang Kil Lee 
 Journal of Gastroenterology and Hepatology, Vol.30(1) : 75-81, 2015 
Journal Title
 Journal of Gastroenterology and Hepatology 
Issue Date
BACKGROUND AND AIM: Metachronous recurrence often occurs after endoscopic submucosal dissection for early gastric cancer, and a method for preventing recurrence is unknown. We aimed to identify risk factors for metachronous lesions, and the effects of aspirin use and Helicobacter pylori eradication on preventing recurrence. METHODS: A total of 1041 consecutive patients who underwent endoscopic submucosal dissection for early gastric cancer between January 2007 and December 2011 were retrospectively analyzed. Every patient was examined endoscopically at 2, 6, and 12 months after endoscopic submucosal dissection, and then annually. Patients were classified into the metachronous group or non-metachronous group according to the existence of metachronous lesions and subdivided by Helicobacter pylori status into three groups: not infected, eradicated after infection, and not eradicated. RESULTS: At 39 months' median follow-up, metachronous gastric lesions had developed in 35 patients (3.4%), including 16 with dysplasia and 19 cancers. Metachronous group were significantly older than non-metachronous group (P = 0.02). Although non-metachronous group took aspirin more frequently than metachronous group (15.5% vs 5.7%), the difference was statistically insignificant (P = 0.11). In the not eradicated group, the odds ratio of metachronous lesion was 7.762 compared with the not infected group (95% confidence interval, 1.483-60.854; P = 0.02). In the eradicated group, the odd ratio of metachronous lesion was 8.120 compared with not infected group (95% confidence interval, 1.950-58.985; P = 0.01). CONCLUSION: Helicobacter pylori infection was an independent risk factor for metachronous gastric lesions. However, eradication of Helicobacter pylori alone does not prevent all metachronous lesions in an inflamed stomach.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김은혜(Kim, Eun Hye) ORCID logo https://orcid.org/0000-0001-6691-6837
박준철(Park, Jun Chul) ORCID logo https://orcid.org/0000-0001-8018-0010
박찬혁(Park, Chan Hyuk)
신성관(Shin, Sung Kwan)
이상길(Lee, Sang Kil) ORCID logo https://orcid.org/0000-0002-0721-0364
이용찬(Lee, Yong Chan)
이혁(Lee, Hyuk)
정성모(Jung, Sung Mo)
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