Objective To evaluate the efficacy,safety and economy of vonoprazan in the treatment of post-endoscopic submucosal dissection(ESD)ulcer by rapid health technology assessment method,and to provide reference for clinical treatment decision.Methods PubMed,Cochrane Library,Embase,ScienceDirect,CNKI,WanFang Data databases and the official website of health technology assessment(HTA)agency were electronically searched to collect HTA reports,systematic reviews/Meta-analysis and pharmacoeconomic studies of vonoprazan in the treatment of post-ESD ulcer from inception to July 31,2024.Two researchers independently screened literature,extracted data,and comprehensively analyzed the results of the included literature on the basis of literature quality evaluation.Results A total of 8 studies were included,all were systematic reviews/Meta-analysis.In terms of effectiveness,compared with proton pump inhibitors(PPI),vonoprazan significantly increased the overall ulcer healing rate after ESD and more rapid reduction of ulcer area(P<0.05).The results of subgroup analysis showed that there was no significant difference in ulcer healing rate between vonoprazan and PPI treatment at 4 or 8 weeks after ESD(P>0.05).Vonoprazan significantly increased the rate of postoperative ulcer reduction in H.pylori positive patients compared with PPI(P<0.05).In terms of safety,compared with PPI,vonoprazan reduced the incidence of overall adverse events rate(P<0.05).The difference in the incidence of delayed bleeding and ulcer perforation between vonoprazan and PPIs showed no statistically significant difference.(P>0.05).Conclusion Vonoprazan demonstrated favorable efficacy and safety in the treatment of ESD ulcers,and further economic studies are warranted.

Objective To evaluate the efficacy,safety and economy of vonoprazan in the treatment of post-endoscopic submucosal dissection(ESD)ulcer by rapid health technology assessment method,and to provide reference for clinical treatment decision.Methods PubMed,Cochrane Library,Embase,ScienceDirect,CNKI,WanFang Data databases and the official website of health technology assessment(HTA)agency were electronically searched to collect HTA reports,systematic reviews/Meta-analysis and pharmacoeconomic studies of vonoprazan in the treatment of post-ESD ulcer from inception to July 31,2024.Two researchers independently screened literature,extracted data,and comprehensively analyzed the results of the included literature on the basis of literature quality evaluation.Results A total of 8 studies were included,all were systematic reviews/Meta-analysis.In terms of effectiveness,compared with proton pump inhibitors(PPI),vonoprazan significantly increased the overall ulcer healing rate after ESD and more rapid reduction of ulcer area(P<0.05).The results of subgroup analysis showed that there was no significant difference in ulcer healing rate between vonoprazan and PPI treatment at 4 or 8 weeks after ESD(P>0.05).Vonoprazan significantly increased the rate of postoperative ulcer reduction in H.pylori positive patients compared with PPI(P<0.05).In terms of safety,compared with PPI,vonoprazan reduced the incidence of overall adverse events rate(P<0.05).The difference in the incidence of delayed bleeding and ulcer perforation between vonoprazan and PPIs showed no statistically significant difference.(P>0.05).Conclusion Vonoprazan demonstrated favorable efficacy and safety in the treatment of ESD ulcers,and further economic studies are warranted.

OBJECTIVE: To evaluate the safety and prognosis for patients with early esophageal cancer and precancerous lesions after endoscopic submucosal dissection (ESD).
 METHODS: A total of 89 patients were admitted to the Department of internal medicine in the First People's Hospital of Anqing from August 2008 to August 2011. All patients were treated with ESD at the early stage of esophageal cancer and precancerous lesions. The patients' laboratory data and relevant medical history were collected. The postoperative complications and long-term effects of ESD were analyzed.
 RESULTS: Eighty-nine patients were followed up with 100% response rate. Among 89 cases, 16 were early esophageal cancer, 38 were high-grade esophageal neoplasia and 35 were low-grade esophageal neoplasia. The one-time whole piece resection rate, complete resection rate and curative resection rate was 93.3% (84/89), 92.1% (82/89) and 92.1% (82/89), respectively. Two cases suffered intraoperative perforation with a rate of 2.2% and these 2 patients performed the intraoperative endoscopic repair; one case suffered the postoperative delayed bleeding with a rate of 1.1% and the patient underwent the conservative treatment; three cases suffered the esophageal stenosis with a rate of 3.4%. All patients were followed-up for 10-58 (36.3±21.2) months. In this period, one case recurred after ESD for 3 years with a rate of 1.1%; two cases were dead. The three-year survival rate was 97.8%.
 CONCLUSION The early esophageal cancer and precancerous lesions can be treated with ESD. The method is safe and the prognosis is good.
Dissection ; Endoscopy ; adverse effects ; Esophageal Neoplasms ; surgery ; Esophageal Perforation ; Esophageal Stenosis ; Humans ; Postoperative Complications ; Postoperative Hemorrhage ; Prognosis