Reviewer's report
Title:Modified endoscopic submucosal dissection with enucleation for treatment
of gastric subepithelial tumors originating from the muscularis propria layer
Version: 1Date:4 June 2012
Reviewer: Arjun Koch
Reviewer's report:
Major points
1. My major concern is to whether there was a correct indication for ESD in the
cases described to begin with. Our current guidelines state that lesions over 3 cm
should be resected. Only 3 lesions in this series were greater than 3 cm of which
one could not be resected endoscopically! Furthermore all lesions proved to be
of a low malignant potential so there was little need for resection. The authors
should explain why they felt that resection was indicated.
2. The authors demonstrate an ESD technique with enucleation for the treatment
of gastric subepithelial tumors originating from the proper muscle layer. Similar
reports have been published recently and should be referenced. (e.g. “Bing-Rong
Liu et al, Endoscopic muscularis dissection for upper gastrointestinal
subepithelial tumors originating from the muscularis propia.” Surg Endosc April
2012)
3. p5. ..."Expectant management with life-long endoscopic screening causes
tremendous economic and emotional burden for these patients"... Were is the
evidence for this statement? Even though this statement seems to be used to
justify resection, a periodic endoscopic follow-up of patients is advised on page
12...
4. There is no concrete description about the usefulness of the modified ESD
technique. The usefulness of modified ESD should be explained more.
5. Although the main theme is ESD for gastric subepithelial tumors originating
from the muscularis propia layer, there is no explanation of Leiomyoma except
GIST in discussion.
Minor points
1. There is no product name of an electrosurgical snare which used to shorten
the procedure time.
2. There is no description about the settings of the HF electric devices.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Modified endoscopic submucosal dissection with enucleation for treatment
of gastric subepithelial tumors originating from the muscularis propria layer
Version: 1Date:4 June 2012
Reviewer: Arjun Koch
Reviewer's report:
Major points
1. My major concern is to whether there was a correct indication for ESD in the
cases described to begin with. Our current guidelines state that lesions over 3 cm
should be resected. Only 3 lesions in this series were greater than 3 cm of which
one could not be resected endoscopically! Furthermore all lesions proved to be
of a low malignant potential so there was little need for resection. The authors
should explain why they felt that resection was indicated.
2. The authors demonstrate an ESD technique with enucleation for the treatment
of gastric subepithelial tumors originating from the proper muscle layer. Similar
reports have been published recently and should be referenced. (e.g. “Bing-Rong
Liu et al, Endoscopic muscularis dissection for upper gastrointestinal
subepithelial tumors originating from the muscularis propia.” Surg Endosc April
2012)
3. p5. ..."Expectant management with life-long endoscopic screening causes
tremendous economic and emotional burden for these patients"... Were is the
evidence for this statement? Even though this statement seems to be used to
justify resection, a periodic endoscopic follow-up of patients is advised on page
12...
4. There is no concrete description about the usefulness of the modified ESD
technique. The usefulness of modified ESD should be explained more.
5. Although the main theme is ESD for gastric subepithelial tumors originating
from the muscularis propia layer, there is no explanation of Leiomyoma except
GIST in discussion.
Minor points
1. There is no product name of an electrosurgical snare which used to shorten
the procedure time.
2. There is no description about the settings of the HF electric devices.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Modified endoscopic submucosal dissection with enucleation for treatment
of gastric subepithelial tumors originating from the muscularis propria layer
Version: 1Date:4 June 2012
Reviewer: Arjun Koch
Reviewer's report:
Major points
1. My major concern is to whether there was a correct indication for ESD in the
cases described to begin with. Our current guidelines state that lesions over 3 cm
should be resected. Only 3 lesions in this series were greater than 3 cm of which
one could not be resected endoscopically! Furthermore all lesions proved to be
of a low malignant potential so there was little need for resection. The authors
should explain why they felt that resection was indicated.
2. The authors demonstrate an ESD technique with enucleation for the treatment
of gastric subepithelial tumors originating from the proper muscle layer. Similar
reports have been published recently and should be referenced. (e.g. “Bing-Rong
Liu et al, Endoscopic muscularis dissection for upper gastrointestinal
subepithelial tumors originating from the muscularis propia.” Surg Endosc April
2012)
3. p5. ..."Expectant management with life-long endoscopic screening causes
tremendous economic and emotional burden for these patients"... Were is the
evidence for this statement? Even though this statement seems to be used to
justify resection, a periodic endoscopic follow-up of patients is advised on page
12...
4. There is no concrete description about the usefulness of the modified ESD
technique. The usefulness of modified ESD should be explained more.
5. Although the main theme is ESD for gastric subepithelial tumors originating
from the muscularis propia layer, there is no explanation of Leiomyoma except
GIST in discussion.
Minor points
1. There is no product name of an electrosurgical snare which used to shorten
the procedure time.
2. There is no description about the settings of the HF electric devices.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
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