Comparison of an Ecabet Sodium and Proton Pump Inhibitor (PPI) Combination Therapy with PPI Alone in the Treatment of Endoscopic Submucosal Dissection (ESD) - induced Ulcers in Early Gastric Cancer: Prospective Randomized Study

Background/Aims: Ecabet sodium (ES) is a widely employed mucoprotective agent, for the treatment of gastric ulcers. The present paper prospectively evaluate the additive benefits of using ES in combination with the rabeprazole proton pump inhibitor (PPI) for the treatment of gastric ulcers after endoscopic submucosal dissection (ESD). Methodology: A total of 56 patients who had undergone ESD for early gastric cancers were randomly assigned to receive either PPI with ES (P/ES group, n=28) or PPI alone (PPI group, n=28) for 8 weeks. At 4 and 8 weeks after ESD, the healing rate and the diminution rate of the ulcers were compared between two groups by endoscopy. Results: One patient in the PPI group developed a hemorrhage as a result of an ESD-induced ulcer. At 4 weeks, the healing rates were significantly higher in the P/ES group (40.7%) compared with the PPI group (11.5%), (p=0.0013). This tendency was observed also at 8 weeks (p=0.0446). In addition, at 4 weeks, the diminution rates of the ESD-induced ulcers were significantly higher in the P/ES group (95.8%) than in the PPI group (84.9%), (p=0.0033). Conclusions: ES in combination with PPI facilitates increased healing of ESD-induced ulcers, and can also improve the quality of ulcer healing.