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Early Attempts to Eradicate Helicobacter pylori after Endoscopic Resection of Gastric Neoplasm Significantly Improve Eradication Success Rates

 Cheal Wung Huh  ;  Young Hoon Youn  ;  Da Hyun Jung  ;  Jae Jun Park  ;  Jie-Hyun Kim  ;  Hyojin Park 
 PLOS ONE, Vol.11(9) : e0162258, 2016 
Journal Title
Issue Date
Aged ; Amoxicillin/therapeutic use* ; Anti-Bacterial Agents/therapeutic use* ; Anti-Ulcer Agents/therapeutic use* ; Clarithromycin/therapeutic use* ; Drug Therapy, Combination ; Endoscopy ; Female ; Helicobacter Infections/complications ; Helicobacter Infections/drug therapy* ; Helicobacter Infections/pathology ; Helicobacter pylori ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/prevention & control ; Proton Pump Inhibitors/therapeutic use* ; Stomach Neoplasms/complications ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Time-to-Treatment ; Treatment Outcome
PURPOSE: After endoscopic resection (ER) of gastric tumors, eradication of Helicobacter pylori (H. pylori) infection is advised to reduce metachronous recurrence. Optimal timing of such therapy (yet to be established) was investigated herein, examining early active and late scarring stages of post-ER iatrogenic ulcers.

MATERIALS AND METHODS: Analysis included 514 patients who received proton-pump inhibitor (PPI)-based triple therapy for H. pylori eradication after ER for gastric neoplasms between January 2008 and June 2015. Clinicopathologic characteristics, particularly the timing of triple therapy, were used to compare eradication rates, assigning patients to early- (≤2 weeks), intermediate- (2-8 weeks), and late-phase (≥8 weeks) treatment groups.

RESULTS: H. pylori eradication rates differed significantly by timing of triple therapy after ER (early, 90.0%; intermediate, 76.2%, late, 72.4%; p <.001). However, eradication success rates were not significantly affected by age, smoking, alcohol consumption, preexisting comorbidity, method of ER, size and location of iatrogenic ulcer, and duration of therapeutic regimen. Early initiation of H. pylori eradication was also identified as a significant independent predictor of eradication success in multivariate analysis (Odds ratio = 3.67, 95% CI 2.18-6.16; p <.001).

CONCLUSION: In patients undergoing ER of gastric tumors, early post-ER attempts at eradication of H. pylori offer the best chance of eradication success.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Park, Jae Jun(박재준)
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Jung, Da Hyun(정다현) ORCID logo https://orcid.org/0000-0001-6668-3113
Huh, Cheal Wung(허철웅)
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