Analysis of the healing process of the gastric ulcer occurring after endoscopic resection

Abstract

Recently, endoscopic resection (ER) has been performed for early gastric cancer or adenoma. After this procedure, a round gastric ulcer 10 to 30 mm in diameter remained. The ulcer was penetrated to the submucosa. This study examined the relationship between Helicobacter pylori (H. pylori) infection and the healing of such an artificial gastric ulcer induced by ER in humans. ER was performed in 45 patients with early gastric cancer or adenoma to resect those lesions. The healing process of the ulcer was followed by endoscopy at 3 days, 2 weeks, 2 months and 6 months after ER. At each examination, the presence of H. pylori in the gastric mucosa was examined. Biopsy specimens were taken from 3 sites (lesser curvature of the antrum, greater curvature of the gastric body and ulcer edge), and cultured in Dent's medium for detection of H. pylori. Three days after ER, all ulcers remained in the active stage, but 2 months after ER, all ulcers had healed up to scar formation peyard less of whether H. pylori was positive or negative in the gastric mucosa adjacent to the ulcer. No relapse of ulcer was recognized up to 490 days in the longest follow up (average 296. 1 days) after the ulcer had healed. The detection rate of H. pylori at the time of ER was 34.1% and 6 months after ER, it was 65.4%. In conclusion, the healing process of gastric ulcer induced by ER was not retarded by H. pylori infection, and relapse of the ulcer was not recognized. It is concluded that there is no causal relationship between H. pylori infection and the healing process or relapse of gastric ulcers induced by ER.