Rationalization Of Acid-suppressing Drugs After Endoscopic Submucosal Dissection Of Upper Gastrointestinal Lesions

PurposeThrough a multi-center study of new techniques for minimally invasive endoscopic minimally invasive resection,based on previous data review,prospective clinical trials and large-scale literature reading,establish a consensus or standardized protocol for endoscopic diagnosis and treatment of digestive tract diseases.To further improve the safety,effectiveness and feasibility of new techniques for endoscopic resection,and further promote the promotion and improvement of new techniques for endoscopic resection.This topic focuses on the use of gastric acid drugs(proton pump inhibitor)after endoscopic minimally invasive surgery.Method1.Determine the subjects,and develop the inclusion criteria,exclusion criteria,and grouping criteria.2.Patients who enter the group were informed,and signed his or her name on the patient notice if he or she agrees.3.According to the patient's condition,the corresponding upper gastrointestinal lesion endoscopic resection was performed.Then the patients were grouped to low-risk,moderate-risk and high-risk groups according to the grouping criteria.4.Several patients in each group were randomly divided into experimental group and control group,all of whom were treated with standard dose of PPI.5 Standard dose PPI was given to the patients at different times according to the patient's experimental grouping.6.All patients underwent gastroscopy 4 weeks after surgery to evaluate the size of the wound,the healing of the ulcer,and the occurrence of complications such as bleeding and perforation,as well as ulcer-related symptoms such as abdominal pain and upper abdominal discomfort.7.Statistical analysis.Results1.With the increase of risk,the incidence of postoperative complications(such as bleeding,perforation,etc.)and ulcer-related symptoms(abdominal pain,upper abdominal discomfort,etc.)increased.There was a statistically significant difference in the incidence of ulcer-related symptoms(P<0.05).There was also a statistically significant difference in the incidence of complications and ulcer-related symptoms between the high-risk control group,the intermediate-risk control group and the low-risk control group(P<0.05).2.There was no significant difference in the size and healing of the wounds between the low-risk experimental group and the low-risk control group at 4 weeks after gastrointestinal endoscopic resection(P>0.05).There was no significant difference in the incidence of complications and ulcer-related symptoms.(P>0.05)too.3.Gastroscopy was performed 4 weeks after endoscopic laparoscopic surgery in the moderate-risk experimental group and the moderate-risk control group.The size and healing of the wounds were statistically different(P<0.05),and the incidence of complications and ulcer-related symptoms were also statistically different.(P<0.05),the wound healing of the moderate-risk experimental group was lower than that of the moderate-risk control group,and the incidence of complications and ulcer-related symptoms was higher than that of the moderate-risk control group.4.Gastroscopy was performed 4 weeks after endoscopic laparoscopic surgery in the high-risk experimental group and the high-risk control group.The size and healing of the wounds were statistically different(P<0.05),and the incidence of complications and ulcer-related symptoms were also statistically different.(P<0.05),the wound healing of the high-risk experimental group was lower than that of the high-risk control group,and the incidence of complications and ulcer-related symptoms was higher than that of the high-risk control group.Conclusion1.In the case of complete resection of the lesion,the wound should be minimized to reduce the incidence of postoperative complications and ulcer-related symptoms.2.In patients with small endoscopic wounds without associated complications and high risk factors,the PPI use time can be reduced.3.For patients with endoscopic wounds between 20 mm and 40 mm or lesions located in the esophagus/duodenum,the benefit of PPI is greater for a full range of foot treatments.4.For patients with endoscopic wounds greater than 40 mm or with various high-risk factors or full-thickness resection,the benefit of PPI is greater for a full range of foot treatments.