J Korean Med Sci.  2007 Dec;22(6):1055-1059. 10.3346/jkms.2007.22.6.1055.

A Prospective Randomized Trial of Either Famotidine or Pantoprazole for the Prevention of Bleeding after Endoscopic Submucosal Dissection

• Jeong HK
• Park CH
• Jun CH
• Lee GH
• Kim HI
• Kim HS
• Choi SK
• Rew JS

• KMID: 1785769
• DOI: http://doi.org/10.3346/jkms.2007.22.6.1055

Abstract

Endoscopic submucosal dissection (ESD) has been reported to have a higher bleeding rate than conventional methods. However, there are few reports on whether a proton pump inhibitor or a histamine2-receptor antagonist is the more effective treatment for preventing bleeding after ESD. In a prospective trial, patients undergoing ESD due to gastric adenoma or adenocarcinoma were randomly assigned to pantoprazole or famotidine. Both drugs were given intravenously for the first 2 days, thereafter by mouth. Eighty-five in the pantoprazole group and 79 in the famotidine group were included for analysis. Primary outcome measure was the delayed bleeding rate. Clinical characteristics were not different between the two groups. The delayed bleeding rate was significantly lower in the pantoprazole group compared with the famotidine group (3.5% vs. 12.7%, p=0.031). On multivariate analysis, the preventive use of pantoprazole (relative hazard: 0.220, 95% CI: 0.051- 0.827, p=0.026) and the specimen size (> or =34 mm, relative hazard: 4.178, 95% CI: 1.229-14.197, p=0.022) were two independent factors predictive of delayed bleeding. There were no significant differences in en bloc and complete resection rate between the two groups. In conclusion, pantoprazole is more effective than famotidine for the prevention of delayed bleeding after ESD.

Keyword

Endoscopy; Hemorrhage; Famotidine; Pantoprazole

MeSH Terms

2-Pyridinylmethylsulfinylbenzimidazoles/*therapeutic use
Aged
Anti-Ulcer Agents/*therapeutic use
Dissection
Famotidine/*therapeutic use
Female
Gastric Mucosa/*surgery
Gastrointestinal Hemorrhage/*prevention & control
*Gastroscopy
Humans
Male
Middle Aged
Postoperative Hemorrhage/*prevention & control
Prospective Studies
Single-Blind Method
Stomach Neoplasms/*surgery

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