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  • 1
    Online Resource
    Online Resource
    Vonoprazan is Superior to Rabeprazole for Healing Endoscopic Submucosal Dissection: Induced Ulcers
    S. Karger AG ; 2018
    In:  Digestion Vol. 97, No. 2 ( 2018), p. 170-176
    Details
    In: Digestion, S. Karger AG, Vol. 97, No. 2 ( 2018), p. 170-176
    Abstract: 〈 b 〉 〈 i 〉 Background and Aims: 〈 /i 〉 〈 /b 〉 Endoscopic submucosal dissection (ESD) is a well-established minimally invasive treatment for early gastric cancer. To heal ESD-induced ulcers, we commonly prescribe proton pump inhibitors (PPIs). Vonoprazan is our new choice, which is reported to have a stronger and longer acid inhibitory effect than existing PPIs. Here, we aimed to evaluate the efficacy of vonoprazan for healing ESD-induced ulcers compared with rabeprazole. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We reviewed 190 patients who underwent ESD before and after we switched the acid secretion inhibitor from rabeprazole to vonoprazan. We evaluated scarring and reduction rates at 4 weeks after ESD. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Scarring rates were not different between vonoprazan and rabeprazole (31.7 vs. 18.9%; 〈 i 〉 p 〈 /i 〉  = 0.07). However, for ulcers ≤35 mm, vonoprazan was superior to rabeprazole (42.2 vs. 19.2%; 〈 i 〉 p 〈 /i 〉   & #x3c; 0.05). Reduction rates were superior for vonoprazan compared with rabeprazole (93.0 vs. 90.4%; 〈 i 〉 p 〈 /i 〉   & #x3c; 0.05). In multivariate analysis, vonoprazan was superior to rabeprazole for ulcer scarring (OR 2.21; 〈 i 〉 p 〈 /i 〉   & #x3c; 0.05), and ulcer location in the lower-third of the stomach had higher risk of incomplete scarring (OR 0.37; 〈 i 〉 p 〈 /i 〉   & #x3c; 0.05). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Vonoprazan was superior to rabeprazole for healing ESD-induced ulcers.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000485028
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1482218-0
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Study on Clinical Factors Involved in 〈b〉〈i〉Helicobacter pylori〈/i〉〈/b〉-Uninfected, Undifferentiated-Type Early Gastric Cancer
    S. Karger AG ; 2017
    In:  Digestion Vol. 96, No. 4 ( 2017), p. 213-219
    Details
    In: Digestion, S. Karger AG, Vol. 96, No. 4 ( 2017), p. 213-219
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The factors associated with the pathogenesis of 〈 i 〉 Helicobacter pylori 〈 /i 〉 -uninfected undifferentiated-type early gastric cancer (HPUGC) remain unclear. This study compared patient characteristics, including medical history and alcohol/tobacco use, of HPUGC patients with characteristics of patients with 〈 i 〉 H. pylori 〈 /i 〉 -positive undifferentiated-type early gastric cancer (HPPGC) to clarify and gain understanding on those differences that could play a role in the pathogenesis. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This retrospective study included 282 patients who were treated endoscopically from March 2005 to March 2014. This cohort consisted of 232 patients with HPPGC (82.3%) and 50 patients with HPUGC (17.7%). Patient characteristics were analyzed by subgroups of HPUGC vs. HPPGC, with comparisons for age, gender, cancer history, comorbidity of lifestyle diseases requiring medication (hypertension, type 2 diabetes, and dyslipidemia), cumulative amount of alcohol consumption, and smoking history (Brinkman index [BI]). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 HPUGC patients were typically younger, had less frequent hypertension, and had higher BI values ( 〈 i 〉 p 〈 /i 〉   & #x3c; 0.05 for all parameters). In a younger non-hypertensive subgroup, the OR for high BI (BI ≥340) in the HPUGC group vs. HPPGC group was 5.049 (95% CI 2.458–10.373, 〈 i 〉 p 〈 /i 〉   & #x3c; 0.0001). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The investigation of clinical factors identified smoking history as being possibly contributing to the pathogenesis of HPUGC. Future research is necessary at the cellular and genetic levels.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000481817
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482218-0
    Location Call Number Limitation Availability
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Usefulness of Magnifying Endoscopy with Narrow-Band Imaging for Diagnosing Mixed Poorly Differentiated Gastric Cancers
    S. Karger AG ; 2021
    In:  Digestion Vol. 102, No. 6 ( 2021), p. 938-945
    Details
    In: Digestion, S. Karger AG, Vol. 102, No. 6 ( 2021), p. 938-945
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Curative rates of endoscopic treatment for undifferentiated-type early gastric cancer (EGC), particularly mixed poorly differentiated adenocarcinoma (MIXED-POR), are lower than those of endoscopic treatment for the differentiated type. Magnifying endoscopy with narrow-band imaging (ME-NBI) is useful for diagnoses of the histological type. This study aimed to investigate the detection rates of MIXED-POR among undifferentiated-type EGCs using biopsy and ME-NBI in order to improve curative rates through endoscopic treatment. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We analyzed 267 lesions initially subjected to endoscopic submucosal resection (ESD) and histologically diagnosed as undifferentiated-type EGCs between July 2005 and December 2016 at our hospital. We obtained written informed consent from all participants. Biopsy and ME-NBI findings were compared to distinguish pure signet ring cell carcinoma (PURE-SIG) and MIXED-POR. ME-NBI findings were divided into 2 categories depending on the presence of irregular vessels. Results of biopsy and ME-NBI (combination method) were also analyzed, and detection rates of MIXED-POR and PURE-SIG were evaluated in terms of sensitivity, specificity, and accuracy. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Overall, 114 lesions were analyzed. Fifty-eight lesions (50.9%) were identified as MIXED-POR. With biopsy, the detection rate of MIXED-POR was significantly lower than that of PURE-SIG ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.0001). ME-NBI detected significantly more MIXED-POR with irregular vessels than PURE-SIG ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.0001). The combination method could detect significantly more MIXED-POR than PURE-SIG ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.0001). The sensitivity and accuracy for MIXED-POR diagnosis were significantly higher with the combination method than with biopsy alone ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.0001). 〈 b 〉 〈 i 〉 Discussion/Conclusion: 〈 /i 〉 〈 /b 〉 Combining biopsy and ME-NBI improved the accuracy of pretreatment diagnosis before ESD in undifferentiated-type cancer.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000517970
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1482218-0
    Location Call Number Limitation Availability
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    Online Resource
  • 4
    Online Resource
    Online Resource
    Treatment Outcomes of Endoscopic Submucosal Dissection for Adenocarcinoma Originating from Long-Segment Barrett’s Esophagus versus Short-Segment Barrett’s Esophagus
    S. Karger AG ; 2018
    In:  Digestion Vol. 97, No. 4 ( 2018), p. 316-323
    Details
    In: Digestion, S. Karger AG, Vol. 97, No. 4 ( 2018), p. 316-323
    Abstract: Background: In recent years, effective outcomes of endoscopic submucosal dissection (ESD) for esophagogastric junction cancer including short-segment Barrett’s esophagus (SSBE) cancer have been reported. However, the efficacy of ESD for long-segment Barrett’s esophagus (LSBE) cancer is unknown. Aim: To clarify the treatment outcomes of ESD for LSBE cancer versus SSBE cancer. Methods: A total of 86 patients with 91 superficial Barrett’s esophageal adenocarcinomas who underwent ESD were enrolled; of these, 68 had underlying SSBE and 18 had LSBE. Procedure outcomes and prognosis were compared. Results: There was no significant difference in age and tumor diameter among patients. The only complication observed was stricture, but it was not significant (2 vs. 9%). No significant difference was observed in the negative horizontal margin rates (94.1 vs. 95.7%), R0 resection rates (83.8 vs. 82.6%), curative resection rates (72.1 vs. 73.9%), and noncurative factors. Both LSBE and SSBE cancer showed favorable 3-year overall survival rates (95.0 vs. 94.4%) in the median observation period of 28.5 months. Conclusions: ESD for LSBE cancer achieved procedure outcomes and short-term prognosis comparable to SSBE. ESD has the potential to be an effective therapeutic option for esophageal neoplasms in patients with LSBE.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000486197
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1482218-0
    Location Call Number Limitation Availability
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    Online Resource
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