Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0039
Donghoon Kang, Jae Myeong Park, Sung-Hak Lee, Y. Cho, Bo-In Lee, Myung-Gyu Choi
Objectives: Adenosine triphosphate-binding cassette subfamily G member 2 (ABCG2) and CD133 are recognized stem cell markers of gastric cancer. Extensive research has examined the significance of these markers in different types of cancers and their impact on prognoses, linking them to unfavorable clinical outcomes in various tumors. However, the prognostic value of these markers for gastric cancer remains unclear. We investigated the expression of ABCG2 and CD133 and their relationship with clinical outcomes in gastric cancer.Methods: ABCG2 and CD133 expression levels were analyzed, using immunohistochemistry and tissue microarrays, in tumor samples from 459 patients who underwent surgical resections due to gastric cancer. ABCG2 and CD133 expression levels were defined by intensity and dichotomized as medians. The associations among the expression levels of these markers, disease severity, and patient survival were also determined.Results: In the 411 patients for whom we analyzed the expression levels of these markers, 74.9% and 80.5% were found to have high levels of ABCG2 and CD133, respectively. High expression levels of ABCG2 and CD133 were more commonly observed in well-differentiated (p<0.001 and p=0.004, respectively) and intestinal lesions (p<0.001 and p=0.002, respectively). High ABCG2 expression correlated with improved survival outcomes, whereas high CD133 expression was associated with poorer outcomes. Cox regression analysis confirmed that stage, high ABCG2 (overall survival [OS]: hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.41–0.91; p=0.015; recurrencefree survival [RFS]: HR, 0.55; 95% CI, 0.34–0.88; p=0.012), and CD133 expression (OS: HR, 1.59; 95% CI, 1.00–2.51; p=0.049; RFS: HR, 2.29; 95% CI, 1.21–4.34; p=0.011) were predictors of survival. A subgroup analysis indicated that ABCG2 expression was also associated with an improved RFS rate in patients who received systemic chemotherapy.Conclusions: High ABCG2 expression and low CD133 expression in tumors correlated with improved survival outcomes in post-resection patients with gastric cancer, suggesting their potential utility as prognostic biomarkers.
{"title":"Outcomes Associated With ABCG2 and CD133 Expression in Patients With Gastric Cancer After Surgical Resection","authors":"Donghoon Kang, Jae Myeong Park, Sung-Hak Lee, Y. Cho, Bo-In Lee, Myung-Gyu Choi","doi":"10.7704/kjhugr.2023.0039","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0039","url":null,"abstract":"Objectives: Adenosine triphosphate-binding cassette subfamily G member 2 (ABCG2) and CD133 are recognized stem cell markers of gastric cancer. Extensive research has examined the significance of these markers in different types of cancers and their impact on prognoses, linking them to unfavorable clinical outcomes in various tumors. However, the prognostic value of these markers for gastric cancer remains unclear. We investigated the expression of ABCG2 and CD133 and their relationship with clinical outcomes in gastric cancer.Methods: ABCG2 and CD133 expression levels were analyzed, using immunohistochemistry and tissue microarrays, in tumor samples from 459 patients who underwent surgical resections due to gastric cancer. ABCG2 and CD133 expression levels were defined by intensity and dichotomized as medians. The associations among the expression levels of these markers, disease severity, and patient survival were also determined.Results: In the 411 patients for whom we analyzed the expression levels of these markers, 74.9% and 80.5% were found to have high levels of ABCG2 and CD133, respectively. High expression levels of ABCG2 and CD133 were more commonly observed in well-differentiated (p<0.001 and p=0.004, respectively) and intestinal lesions (p<0.001 and p=0.002, respectively). High ABCG2 expression correlated with improved survival outcomes, whereas high CD133 expression was associated with poorer outcomes. Cox regression analysis confirmed that stage, high ABCG2 (overall survival [OS]: hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.41–0.91; p=0.015; recurrencefree survival [RFS]: HR, 0.55; 95% CI, 0.34–0.88; p=0.012), and CD133 expression (OS: HR, 1.59; 95% CI, 1.00–2.51; p=0.049; RFS: HR, 2.29; 95% CI, 1.21–4.34; p=0.011) were predictors of survival. A subgroup analysis indicated that ABCG2 expression was also associated with an improved RFS rate in patients who received systemic chemotherapy.Conclusions: High ABCG2 expression and low CD133 expression in tumors correlated with improved survival outcomes in post-resection patients with gastric cancer, suggesting their potential utility as prognostic biomarkers.","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"2 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0052
Joonhee Han, Heung Up Kim, Sejin Kim, Hyun Joo Song
Anisakiasis is a zoonotic parasitic infection associated with consumption of raw fish or uncooked seafood. We report a rare case of suspected esophageal anisakiasis-induced dysphagia. A 66-year-old man patient without any medical history was admitted to our hospital for evaluation of acute dysphagia. Following intake of abalone sashimi for dinner, he experienced sudden difficulty with swallowing the day before his emergency department visit. He developed skin rash and pruritus throughout his body, shortly thereafter. He also had chest and upper abdominal pain and diarrhea. He had experienced similar symptoms after consumption of raw fish on two previous occasions. Dysphagia improved 9 days later. Gastroscopy performed after symptom onset showed small erosions and edematous mucosa in the mid esophagus. Abdominopelvic computed tomography (CT) showed distal esophageal wall thickening and small bowel obstruction with concomitant ascites. We suspected anisakiasis based on the following criteria: 1) Skin rash after the third episode of consumption of raw fish or seafood (anisakiasisspecific immunoglobulin E class 4). 2) CT-documented small intestinal obstruction and ascites. 3) Eosinophil-dominant fluid observed on ascitic fluid analysis. Therefore, it is reasonable to conclude that temporary dysphagia in this patient was attributable to esophageal anisakiasis associated with raw seafood consumption.
{"title":"A Case of Suspected Acute Esophageal Anisakiasis With Dysphagia","authors":"Joonhee Han, Heung Up Kim, Sejin Kim, Hyun Joo Song","doi":"10.7704/kjhugr.2023.0052","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0052","url":null,"abstract":"Anisakiasis is a zoonotic parasitic infection associated with consumption of raw fish or uncooked seafood. We report a rare case of suspected esophageal anisakiasis-induced dysphagia. A 66-year-old man patient without any medical history was admitted to our hospital for evaluation of acute dysphagia. Following intake of abalone sashimi for dinner, he experienced sudden difficulty with swallowing the day before his emergency department visit. He developed skin rash and pruritus throughout his body, shortly thereafter. He also had chest and upper abdominal pain and diarrhea. He had experienced similar symptoms after consumption of raw fish on two previous occasions. Dysphagia improved 9 days later. Gastroscopy performed after symptom onset showed small erosions and edematous mucosa in the mid esophagus. Abdominopelvic computed tomography (CT) showed distal esophageal wall thickening and small bowel obstruction with concomitant ascites. We suspected anisakiasis based on the following criteria: 1) Skin rash after the third episode of consumption of raw fish or seafood (anisakiasisspecific immunoglobulin E class 4). 2) CT-documented small intestinal obstruction and ascites. 3) Eosinophil-dominant fluid observed on ascitic fluid analysis. Therefore, it is reasonable to conclude that temporary dysphagia in this patient was attributable to esophageal anisakiasis associated with raw seafood consumption.","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"1 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0059
Jong Kyu Park
{"title":"The Recurrence of Helicobacter pylori Infection: Recrudescence Versus Reinfection","authors":"Jong Kyu Park","doi":"10.7704/kjhugr.2023.0059","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0059","url":null,"abstract":"","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"7 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0056
Sang Hoon Kim
Patients with upper gastrointestinal tract cancers frequently develop severe malnutrition during treatment. Optimal nutritional management is imperative to enhance the efficacy of both chemotherapeutic and surgical interventions. In this article, various methods for nutritional screening and assessment, including a range of biochemical assays and decision-making frameworks relevant to clinical settings. We have described pre- and postoperative nutritional strategies and highlighted the established practical guidelines. Additionally, we investigated the key aspects of nutritional oversight during oncological treatment and emphasize the significance of a multidisciplinary approach that involves the services of physicians, dietitians, and nurses. We have outlined specific strategies to facilitate interprofessional collaboration in this setting.
{"title":"Nutritional Strategies for Patients With Upper Gastrointestinal Cancers","authors":"Sang Hoon Kim","doi":"10.7704/kjhugr.2023.0056","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0056","url":null,"abstract":"Patients with upper gastrointestinal tract cancers frequently develop severe malnutrition during treatment. Optimal nutritional management is imperative to enhance the efficacy of both chemotherapeutic and surgical interventions. In this article, various methods for nutritional screening and assessment, including a range of biochemical assays and decision-making frameworks relevant to clinical settings. We have described pre- and postoperative nutritional strategies and highlighted the established practical guidelines. Additionally, we investigated the key aspects of nutritional oversight during oncological treatment and emphasize the significance of a multidisciplinary approach that involves the services of physicians, dietitians, and nurses. We have outlined specific strategies to facilitate interprofessional collaboration in this setting.","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"7 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0038
Kwon-Eui Hong, Yeon Ji Kim, Yoon Jung Choi
Mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) of the gastrointestinal tract, particularly gastric MiNENs are rare, and a gastric adenoma that occurs concomitant with a neuroendocrine carcinoma (and not gastric adenocarcinoma) is extremely rare. The clinicopathologic and pathogenetic features of MiNENs remain unclear, and treatment guidelines are currently unavailable. A 75-year-old man patient was referred to our hospital for management of a gastric adenoma. Endoscopy revealed an elevated mucosal lesion (10 mm×10 mm) at the greater curvature of the lower gastric body. The patient underwent endoscopic submucosal dissection for removal of the gastric neoplasm. Histopathological evaluation revealed mixed epithelial dysplasia, low and partly high grade and a neuroendocrine tumor (grade 1). Immunohistochemical analysis showed neoplastic cells with immunopositivity for CD56, synaptophysin, and INSM1, and Ki-67 showed 2.2%. Therefore, the patient was diagnosed with a low-grade gastric MiNEN. We present a rare case of gastric MiNENs (adenoma-neuroendocrine tumor) together with a literature review.
{"title":"A Case of Gastric Mixed Neuroendocrine-Nonneuroendocrine Neoplasm Composed With Adenoma and Neuroendocrine Tumor","authors":"Kwon-Eui Hong, Yeon Ji Kim, Yoon Jung Choi","doi":"10.7704/kjhugr.2023.0038","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0038","url":null,"abstract":"Mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) of the gastrointestinal tract, particularly gastric MiNENs are rare, and a gastric adenoma that occurs concomitant with a neuroendocrine carcinoma (and not gastric adenocarcinoma) is extremely rare. The clinicopathologic and pathogenetic features of MiNENs remain unclear, and treatment guidelines are currently unavailable. A 75-year-old man patient was referred to our hospital for management of a gastric adenoma. Endoscopy revealed an elevated mucosal lesion (10 mm×10 mm) at the greater curvature of the lower gastric body. The patient underwent endoscopic submucosal dissection for removal of the gastric neoplasm. Histopathological evaluation revealed mixed epithelial dysplasia, low and partly high grade and a neuroendocrine tumor (grade 1). Immunohistochemical analysis showed neoplastic cells with immunopositivity for CD56, synaptophysin, and INSM1, and Ki-67 showed 2.2%. Therefore, the patient was diagnosed with a low-grade gastric MiNEN. We present a rare case of gastric MiNENs (adenoma-neuroendocrine tumor) together with a literature review.","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0053
Sung Jin Lim, Han Mo Yoo, Seung-Woo Lee, Hae Joung Sul, Dong Soo Lee
An increase in the volume of endoscopic procedures performed in recent times has led to increasing detection rates of asymptomatic gastrointestinal subepithelial tumors. However, accurate diagnosis and risk assessment of these tumors preoperatively is challenging. A 70-year-old man patient visited the emergency department for evaluation of melena. Emergency endoscopy revealed an ulcerated subepithelial tumor (8 cm in size) in the gastric cardia and fundus. Computed tomography and upper endoscopy performed at another hospital 6 months earlier were reviewed; the mass showed a significant increase in size (from 2 cm to 8 cm). The patient underwent surgical resection of the mass and was diagnosed with a high-risk gastrointestinal stromal tumor (GIST). In this article, we describe a rare case of a rapidly growing GIST at a rate significantly greater than commonly reported rates.
{"title":"Rapidly Growing, High-Risk Gastrointestinal Stromal Tumor of the Stomach: A Case Report","authors":"Sung Jin Lim, Han Mo Yoo, Seung-Woo Lee, Hae Joung Sul, Dong Soo Lee","doi":"10.7704/kjhugr.2023.0053","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0053","url":null,"abstract":"An increase in the volume of endoscopic procedures performed in recent times has led to increasing detection rates of asymptomatic gastrointestinal subepithelial tumors. However, accurate diagnosis and risk assessment of these tumors preoperatively is challenging. A 70-year-old man patient visited the emergency department for evaluation of melena. Emergency endoscopy revealed an ulcerated subepithelial tumor (8 cm in size) in the gastric cardia and fundus. Computed tomography and upper endoscopy performed at another hospital 6 months earlier were reviewed; the mass showed a significant increase in size (from 2 cm to 8 cm). The patient underwent surgical resection of the mass and was diagnosed with a high-risk gastrointestinal stromal tumor (GIST). In this article, we describe a rare case of a rapidly growing GIST at a rate significantly greater than commonly reported rates.","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"6 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0055
D. Ryu, C. Choi
{"title":"Esophageal Mass With Asymptomatic Hyponatremia","authors":"D. Ryu, C. Choi","doi":"10.7704/kjhugr.2023.0055","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0055","url":null,"abstract":"","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"12 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0057
Seung Young Kim
Obesity is a global health concern associated with a wide range of diseases, including diabetes, metabolic syndrome, fatty liver, and cardiovascular conditions. Recent studies highlight the significant role of gut microbiota in obesity. Research indicates notable changes in the composition and diversity of gut microbiota in individuals diagnosed with obesity. The gut microbiota participate in energy metabolism, lipid synthesis, and regulation of inflammation and therefore play a key role in the pathogenesis of obesity. Therapeutic approaches based on the use of probiotics, prebiotics, Akkermansia muciniphila, and fecal microbiota transplantation have shown promise in animal studies as useful strategies against obesity and metabolic syndrome. However, further research is warranted to conclusively establish the specific strains, dosages, and mechanisms underlying the effectiveness of these novel strategies against obesity in humans.
{"title":"Gut Microbiota and Obesity","authors":"Seung Young Kim","doi":"10.7704/kjhugr.2023.0057","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0057","url":null,"abstract":"Obesity is a global health concern associated with a wide range of diseases, including diabetes, metabolic syndrome, fatty liver, and cardiovascular conditions. Recent studies highlight the significant role of gut microbiota in obesity. Research indicates notable changes in the composition and diversity of gut microbiota in individuals diagnosed with obesity. The gut microbiota participate in energy metabolism, lipid synthesis, and regulation of inflammation and therefore play a key role in the pathogenesis of obesity. Therapeutic approaches based on the use of probiotics, prebiotics, Akkermansia muciniphila, and fecal microbiota transplantation have shown promise in animal studies as useful strategies against obesity and metabolic syndrome. However, further research is warranted to conclusively establish the specific strains, dosages, and mechanisms underlying the effectiveness of these novel strategies against obesity in humans.","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"2 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0058
Han Jo Jeon
Percutaneous endoscopic gastrostomy (PEG) is the modality of choice for long-term enteral feeding in patients in whom oral intake is challenging. Compared with parenteral nutrition, gastrostomy feeding is the preferred choice for sustained nutritional support. Delivery of nutrients directly to the gastrointestinal tract and enhanced cellular immunity associated with this approach are clinically beneficial to patients. Endoscopic gastrostomy is favored for its high clinical success rates and economic advantages and is associated with minor discrepancies with regard to morbidity, mortality, and tube function compared with surgical gastrostomy. PEG procedures can be broadly classified into the pull- and push-types. Although PEG is a comparatively safe procedure, high risk of bleeding is a well-known complication of PEG placement, which necessitates prophylactic antibiotic therapy and careful periprocedural management in patients who receive antiplatelet and anticoagulant agents. Tube dislodgement, peristomal leakage, or infection following PEG placement may require tube replacement or removal. In this review, we investigated the concerns associated with early vs. delayed feeding in concordance with current guidelines. We also describe the indications for PEG tube insertion, post-procedural care strategies, and management of complications.
{"title":"Percutaneous Endoscopic Gastrostomy: Insertion and Management","authors":"Han Jo Jeon","doi":"10.7704/kjhugr.2023.0058","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0058","url":null,"abstract":"Percutaneous endoscopic gastrostomy (PEG) is the modality of choice for long-term enteral feeding in patients in whom oral intake is challenging. Compared with parenteral nutrition, gastrostomy feeding is the preferred choice for sustained nutritional support. Delivery of nutrients directly to the gastrointestinal tract and enhanced cellular immunity associated with this approach are clinically beneficial to patients. Endoscopic gastrostomy is favored for its high clinical success rates and economic advantages and is associated with minor discrepancies with regard to morbidity, mortality, and tube function compared with surgical gastrostomy. PEG procedures can be broadly classified into the pull- and push-types. Although PEG is a comparatively safe procedure, high risk of bleeding is a well-known complication of PEG placement, which necessitates prophylactic antibiotic therapy and careful periprocedural management in patients who receive antiplatelet and anticoagulant agents. Tube dislodgement, peristomal leakage, or infection following PEG placement may require tube replacement or removal. In this review, we investigated the concerns associated with early vs. delayed feeding in concordance with current guidelines. We also describe the indications for PEG tube insertion, post-procedural care strategies, and management of complications.","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"3 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.7704/kjhugr.2023.0042
Yuria Kim, J. Ahn, H. Jung, J. Noh, H. Na, Kee Wook Jung, Jeong Hoon Lee, D. Kim, K. Choi, H. Song, G. Lee
Objectives: The incidence of treatment failures following standard triple therapy (STT) for Helicobacter pylori eradication (HPE) has reached an unacceptable level. Sequential therapy (SQ) has emerged as a promising approach to counteract the escalation of antibiotic resistance. In this study, we used a chronological cohort dataset to conduct a comparative analysis of the eradication rates, compliance, and adverse events associated with the 7-day STT and SQ.Methods: A total of 789 patients underwent HPE treatment at Asan Medical Center between July 2013 and August 2017. Among them, 378 received a 7-day STT and 411 received a 10-day SQ. Baseline clinical data and treatment parameters were compared between the two treatment groups.Results: SQ demonstrated an eradication rate of 84.7% (348/411), which was superior to that of the 7-day STT (74.1%; p<0.001). The incidence of adverse events was also higher in the SQ group than in the STT group (17.5% vs. 11.1%; p=0.01). Nonetheless, treatment compliance was not significantly different between the groups (98.1% [SQ] vs. 96.8% [STT]; p=0.38). Among the patients undergoing second-line eradication, the SQ group displayed a lower eradication rate than the STT group (77.8% vs. 92.4%; p=0.028). Notably, the overall eradication rate did not differ significantly between the two groups (98.3% [STT] vs. 97.4% [SQ]; p=0.56).Conclusions: SQ exhibited superior efficacy compared with the 7-day STT as a first-line H. pylori treatment. Thus, SQ holds potential to serve as the replacement for the 7-day STT in treatment-naïve patients.
目的:标准三联疗法(STT)根除幽门螺杆菌(HPE)后治疗失败的发生率已达到不可接受的水平。序贯治疗(SQ)已成为对抗抗生素耐药性升级的一种有希望的方法。在这项研究中，我们使用时间顺序队列数据集对与7天STT和SQ相关的根除率、依从性和不良事件进行了比较分析。方法:2013年7月至2017年8月在峨山医疗中心接受HPE治疗的789例患者。其中378人接受了7天的STT, 411人接受了10天的SQ。比较两组患者的基线临床资料和治疗参数。结果:SQ的根除率为84.7%(348/411)，优于7 d STT的根除率(74.1%;p < 0.001)。SQ组的不良事件发生率也高于STT组(17.5% vs 11.1%;p = 0.01)。然而，治疗依从性在两组间无显著差异(98.1% [SQ] vs. 96.8% [STT];p = 0.38)。在接受二线根除的患者中，SQ组的根除率低于STT组(77.8% vs. 92.4%;p = 0.028)。值得注意的是，两组之间的总体根除率无显著差异(98.3% [STT] vs. 97.4% [SQ];p = 0.56)。结论:与7天STT相比，SQ作为幽门螺旋杆菌的一线治疗具有更好的疗效。因此，SQ有可能替代treatment-naïve患者的7天STT。
{"title":"Comparison of Helicobacter pylori Eradication Rates Using Standard Triple Therapy and Sequential Therapy","authors":"Yuria Kim, J. Ahn, H. Jung, J. Noh, H. Na, Kee Wook Jung, Jeong Hoon Lee, D. Kim, K. Choi, H. Song, G. Lee","doi":"10.7704/kjhugr.2023.0042","DOIUrl":"https://doi.org/10.7704/kjhugr.2023.0042","url":null,"abstract":"Objectives: The incidence of treatment failures following standard triple therapy (STT) for Helicobacter pylori eradication (HPE) has reached an unacceptable level. Sequential therapy (SQ) has emerged as a promising approach to counteract the escalation of antibiotic resistance. In this study, we used a chronological cohort dataset to conduct a comparative analysis of the eradication rates, compliance, and adverse events associated with the 7-day STT and SQ.Methods: A total of 789 patients underwent HPE treatment at Asan Medical Center between July 2013 and August 2017. Among them, 378 received a 7-day STT and 411 received a 10-day SQ. Baseline clinical data and treatment parameters were compared between the two treatment groups.Results: SQ demonstrated an eradication rate of 84.7% (348/411), which was superior to that of the 7-day STT (74.1%; p<0.001). The incidence of adverse events was also higher in the SQ group than in the STT group (17.5% vs. 11.1%; p=0.01). Nonetheless, treatment compliance was not significantly different between the groups (98.1% [SQ] vs. 96.8% [STT]; p=0.38). Among the patients undergoing second-line eradication, the SQ group displayed a lower eradication rate than the STT group (77.8% vs. 92.4%; p=0.028). Notably, the overall eradication rate did not differ significantly between the two groups (98.3% [STT] vs. 97.4% [SQ]; p=0.56).Conclusions: SQ exhibited superior efficacy compared with the 7-day STT as a first-line H. pylori treatment. Thus, SQ holds potential to serve as the replacement for the 7-day STT in treatment-naïve patients.","PeriodicalId":22895,"journal":{"name":"The Korean Journal of Helicobacter and Upper Gastrointestinal Research","volume":"13 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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