Tu1729 Comparison of Once and Twice Daily Intravenous PPI Injections for Prevention of Bleeding After Endoscopic Resections

Abstract

invasion (ORZ22.83, 95% CI 4.80-108.46, p!0.001) were the independent factors to predict complete healing of ulceration. Conclusions: Administration of PPI for differentiated EGC with ulcer which meet the expanded criteria is effective to reduce the procedure time and heal the ulcer lesion. In differenciated EGC meeting the expanded criteria for ESD, complete healing of ulcer after PPI administration suggests mucosal cancer. Tu1729 Comparison of Once and Twice Daily Intravenous PPI Injections for Prevention of Bleeding After Endoscopic Resections Sung Woo Jung*, Joo Hee Park, Seung Young Kim, Jong Jin Hyun, Ja Seol Koo, Jong-Jae Park, Hoon Jai Chun, Sang Woo Lee Korea University College of Medicine, Seoul, Korea (the Republic of) Background and Aims: Endoscopic resection(ER) is commonly used to remove gastric neoplasms. However, effective treatment dosing or scheduling of proton pump inhibitors (PPI) for the prevention of delayed bleeding after an ER remains unclear. Patients and Methods: One hundred seventy-six patients with gastric adenoma or early gastric cancer were enrolled. After an endoscopic procedure, each subject was randomly assigned to 40 mg q 24 hourrs (once daily group) or 40 mg q 12 hourrs (twice daily group) of IV pantoprazole for 2 days, and subsequently had 40 mg of oral pantoprazole daily. The second-look endoscopy was performed 2 days after an ER to compare the signs of re-bleeding and ulcer status between two groups. Results: Eighty-five patients were treated with 40 mg q 24 hourrs of IV pantoprazole and 91 patients were treated with 40 mg q 12 hourrs of IV pantoprazole. There were no significant differences in the stigmata of early bleeding at the second-look endoscopy (12.1% in once daily group versus 12.0% in twice daily group, pZ0.414) or in the rate of endoscopic hemostatic procedures for the stigmata (30.8% in once daily group versus 32.7% in twice daily group, pZ0.852). Conclusion: Intravenous injections of 40 mg pantoprazole once or twice daily for 2 days after an ER were evenly effective for the prevention of early bleeding. Tu1730 Clinical Impact of Submucosal Tunneling Endoscopic Resection for the Treatment of Gastric Submucosal Tumors Originating From the Muscularis Propria Layer Quan-Lin Li, Jian-Wei Hu, Chen Zhang, Mei-Dong Xu*, Li-Qing Yao, Ping-Hong Zhou Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai, China Background: Submucosal tunneling endoscopic resection (STER) can be adequately adopted as an effective treatment for subumucosal tumors (SMTs) originating from the muscularis propria (MP) layer at the esophagus and cardia. However, it has been seldom used for gastric SMTs. Our purpose was to evaluate the clinical impact of STER for gastric SMTs arising from the MP layer. Methods: Thirty-two patients with gastric SMTs from the MP layer were retrospectively identified from a prospectively maintained database including a total of 403 consecutive patients with STER. The main outcome measurements were complete resection rate, adverse events, local recurrence and distant metastases during follow-up. Results: Of the 32 lesions, 12 were located in the gastric corpus close to the cardia, 3 in the gastric fundus close to the cardia, 6 in the lesser curvature of the gastric corpus, and 11 in the greater curvature of the gastric antrum. STER was successfully performed in all patients with en bloc resection of tumors. The mean tumor size was 2.3 cm (range 1.0-5.0 cm). The complete resection rate was 100%. The operation time ranged from 25 to 125 min (mean, 51.8 min). All complications related to STER were successfully managed with conservative treatments. Local recurrence or distant metastasis did not occur during a follow-up period of 6-32 months. Conclusion: STER is a safe and effective therapeutic strategy for eligible gastric SMTs originating from the MP layer. Submucosal tunneling in the stomach may be more challenging than that in the esophagus, but does not increase procedure-related adverse events or prevent successful STER for eligible gastric SMTs. Clinical characteristics AB574 GASTROINTESTINAL ENDOSCOPY Volume 81, Sex (female/male), no. 14/18 Mean patient age (range), y 48.1 (31-73) Tumor location, no. Gastric fundus close to the cardia 3 Gastric corpus close to the cardia 12 Lesser curvature of the gastric corpus 6 Greater curvature of the gastric antrum 11 Procedure-related parameters Mean diameter of lesion (range), cm 2.3 (1-5) Mean procedure time (range), min 51.8 (25-125) No. 5S : 2015 Clinical characteristics www.gie En bloc resection rate, % 100%