Advances in the Treatment of Gastric Artificial Ulcers Following Endoscopic Submucosal Dissection (ESD)

Abstract

Endoscopic submucosal dissection (ESD) is the preferred treatment for early gastric cancer and gastric adenomas. However, ESD-induced artificial ulcers leads to pain, bleeding, and delayed healing. In recent years, advances have been made for the treatment of post-ESD ulcers. Currently available treatment options for post-ESD ulcers include proton pump inhibitors and potassium-competitive acid blockers, mucosal protective agents such as rebamimide, and novel biomaterials such as fibrin glue and hydrogel-based products. In addition, advanced imaging technologies such as Doppler probe ultrasound and infrared imaging systems have been adopted to assist in the detection of invisible vessels. These novel approaches have shown promising efficacies in promoting ulcer healing and reducing post-procedure adverse events. Here we review the factors that might influence ulcer healing after ESD and the recent advances in the management of ESD-induced iatrogenic gastric ulcers. Further investigation is warranted regarding their long-term safety, cost-effectiveness, and individualized treatment strategies.

Keywords

artificial ulcer / biomedical materials / early gastric cancer / endoscopic submucosal dissection

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2026 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.