Objectives: Gastric endoscopic submucosal dissection (ESD) is currently astandard procedure. ESD enables en-bloc resection of large lesions, whileinducing larger artificial ulcers to a greater extent than conventional procedures.Several studies have reported that proton pump inhibitors (PPIs) prevent delayed bleedingand expedite the artificial ulcer healing process. Esomeprazole, anS-isomer of omeprazole, is reportedly one of strongest inhibitors ofgastric acid secretion. Previous studies have examined the effectiveness of esomeprazole.Our goal was to verify the effects of esomeprazole on artificial ulcers in a prospectivestudy.

Methods: A total of 185 patients underwent ESD for gastric neoplasms at ourhospital between January 2013 and June 2015. Among these 185 patients, 49 post-ESD scarlesions were included in this prospective trial. First, 20 mg esomeprazole was orallyadministered to all subjects before and after the procedure. We then evaluated the delayedbleeding rate and ulcer scarring rates at 4 weeks and 8 weeks after the procedure by usinga gastric ulcer stage system.

Results: There was one case of delayed bleeding (2.0%).Regardless of Helicobacter pylori infection status, ulcer scarring ratesat weeks 4 and 8 were respectively 28.6% (14/49) and 98% (48/49).

Conclusions: Our resultssuggest that oral administration of esomeprazole alone may be sufficient for prompthealing of artificial gastric ulcers induced by ESD (UMIN000009367).