Open AccessEffects of preoperative proton pump inhibitor administration on bleeding after gastric endoscopic submucosal dissection: A systematic review and meta‐analysis
Author(s) -
Nishizawa Toshihiro,
Suzuki Hidekazu,
Akimoto Teppei,
Maehata Tadateru,
Morizane Toshio,
Kanai Takanori,
Yahagi Naohisa
Publication year - 2016
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640615588023
Subject(s) - medicine , premedication , endoscopic submucosal dissection , meta analysis , cochrane library , proton pump inhibitor , confidence interval , randomized controlled trial , systematic review , cochrane collaboration , gastrointestinal bleeding , gastroenterology , medline , surgery , political science , law
Background and aim The efficacy of using proton pump inhibitors (PPIs) prior to gastric endoscopic submucosal dissection (ESD) to reduce gastric bleeding remains controversial. This study aimed to systematically review the literature to evaluate the efficacy of preoperative PPI use to reduce post‐ESD bleeding. Methods PubMed, the Cochrane library, and the Igaku‐Chuo‐Zasshi database were searched to identify randomized trials eligible for inclusion in the systematic review. Data from four studies (406 patients) were combined to calculate a pooled risk difference (RD) for developing post‐ESD bleeding. Results Compared with patients who received no premedication, the pooled RD for post‐ESD bleeding in patients who received preoperavive PPI was –0.027 (95% confidence interval: –0.070–0.017, p = 0.228), without significant heterogeneity. Preoperavive PPI use significantly increased gastric pH (weighted mean difference: 1.289, 95% CI: 0.227–2.352, p = 0.0174). Conclusions This systematic review and meta‐analysis showed that premedication with PPI had no advantage for the prevention of post‐ESD bleeding, despite increasing gastric pH.