Reviewer ’s report  
 
Title: Endo scopic Ultrasound -guided Transmural Drainage fo r Subphrenic Abscess: Report of 
Two Cases and a Literature Review  
 
Version: 1 Date: 26 Nov 2017  
 
Reviewer: Joan B. Gornals  
 
Reviewer's report:  
 
Reviewer comments to the authors:  
 
The purpose of th is work, entitled 'Endoscopic Ultrasound -guided Transmural Drainage for 
Subphrenic Abscess: Report of Two Cases and a Literature Review.' is to describe a 2 cases from 
one center, and to describe a literature review  
 
 
Abstract and main text is well organize d and well -written, and the content is interesting. But 
some aspects are confusing, unclear or lacking. Lists of several issues with this paper:  
 
 
 
Several issues to comment:  
 
A. Major issues:  
 
- There is a concern in the case#1 regards the timing when dthe E US-TMD was performed. At 17 
days after surgery, plus 4 days of antibiotic, EUS -TD was selected as the drainage method. Was 
this an enough period of time (is less than 4 weeks) for getting a mature abscess wall? It was 
well checked by EUS -image examination?  This was an adherent or non -adherent collection to 
the GI wall? Please, all these questions should be well -explained in the text. Could this things 
change any of the technical aspects? type of balloon catheters? Change of any device? Change 
on the stents type or size?  
 
 
 
- Discussion:  
 
Please, after your experience a literature review, clarify if or give a more clear opinion, regarding 
if external drainage catheter are needed, in the same time of EUS -TMD.  
 
 
Please; review and add if it is true another case of abdominal abscess treted by using a 
lumenapposing metal stent. Alcaide N et al. EUS -guided drainage of liver abscess by using a 
lumen -apposing metal stent(with video). Gastrointest Endosc. 2013 Dec;78(6):941 -2; discussion 
942. doi: 10.1016/j.gie.2013.07.03 4 
 
 
B. Minor issues:  
 
-Case presentations, case#1, pag6, line 22 -32: 
 
Please, it is recommended change the word 'tunnel' to 'ostomy'; add endosonograhy guidance 
(plus fluoroscopic guidance); specify the diameter rage of the balloon catheter (8mm? -10mm?..), 
and the7 -Fr pigtail plastic stent length (in cm).  
 
 
-Case#2, pag 8, line 6 -7: please add the 7fr pigtail stent length and specify the balloon catheter 
size, for a better understanding of the technical aspects.  
 
 
-There were any technical changes between both cases?  
 
 
-Typographies: '7 -Fr double pigtail' or '7F double pigtail'. The same with '6 -Fr naso -abscess 
catheter' or '6 F naso -abscess'.  
 
 
- Discussion: Please, (at page 12, line over 52) consider adding a case of pneumothorax after a 
transesophageal drainage of a paraesophageal pancreatic cpseudocyts using a lumen -apposing 
metal stent (Gornals et al. Endoscopic ultrasound -guided transesophageal drainage of a 
mediastinal pancreatic pseudocyst using a novel lumen -apposing metal stent. Endoscopy. 
2012;44 Suppl 2 UCTN:E211 -2. doi: 10.1055/s -0032 -1309384)  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your co mments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your  comments to the authors.  
 
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your  comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years r eceived reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, o r salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal . I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named  report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Endo scopic Ultrasound -guided Transmural Drainage fo r Subphrenic Abscess: Report of 
Two Cases and a Literature Review  
 
Version: 1 Date: 26 Nov 2017  
 
Reviewer: Joan B. Gornals  
 
Reviewer's report:  
 
Reviewer comments to the authors:  
 
The purpose of th is work, entitled 'Endoscopic Ultrasound -guided Transmural Drainage for 
Subphrenic Abscess: Report of Two Cases and a Literature Review.' is to describe a 2 cases from 
one center, and to describe a literature review  
 
 
Abstract and main text is well organize d and well -written, and the content is interesting. But 
some aspects are confusing, unclear or lacking. Lists of several issues with this paper:  
 
 
 
Several issues to comment:  
 
A. Major issues:  
 
- There is a concern in the case#1 regards the timing when dthe E US-TMD was performed. At 17 
days after surgery, plus 4 days of antibiotic, EUS -TD was selected as the drainage method. Was 
this an enough period of time (is less than 4 weeks) for getting a mature abscess wall? It was 
well checked by EUS -image examination?  This was an adherent or non -adherent collection to 
the GI wall? Please, all these questions should be well -explained in the text. Could this things 
change any of the technical aspects? type of balloon catheters? Change of any device? Change 
on the stents type or size?  
 
 
 
- Discussion:  
 
Please, after your experience a literature review, clarify if or give a more clear opinion, regarding 
if external drainage catheter are needed, in the same time of EUS -TMD.  
 
 
Please; review and add if it is true another case of abdominal abscess treted by using a 
lumenapposing metal stent. Alcaide N et al. EUS -guided drainage of liver abscess by using a 
lumen -apposing metal stent(with video). Gastrointest Endosc. 2013 Dec;78(6):941 -2; discussion 
942. doi: 10.1016/j.gie.2013.07.03 4 
 
 
B. Minor issues:  
 
-Case presentations, case#1, pag6, line 22 -32: 
 
Please, it is recommended change the word 'tunnel' to 'ostomy'; add endosonograhy guidance 
(plus fluoroscopic guidance); specify the diameter rage of the balloon catheter (8mm? -10mm?..), 
and the7 -Fr pigtail plastic stent length (in cm).  
 
 
-Case#2, pag 8, line 6 -7: please add the 7fr pigtail stent length and specify the balloon catheter 
size, for a better understanding of the technical aspects.  
 
 
-There were any technical changes between both cases?  
 
 
-Typographies: '7 -Fr double pigtail' or '7F double pigtail'. The same with '6 -Fr naso -abscess 
catheter' or '6 F naso -abscess'.  
 
 
- Discussion: Please, (at page 12, line over 52) consider adding a case of pneumothorax after a 
transesophageal drainage of a paraesophageal pancreatic cpseudocyts using a lumen -apposing 
metal stent (Gornals et al. Endoscopic ultrasound -guided transesophageal drainage of a 
mediastinal pancreatic pseudocyst using a novel lumen -apposing metal stent. Endoscopy. 
2012;44 Suppl 2 UCTN:E211 -2. doi: 10.1055/s -0032 -1309384)  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your co mments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your  comments to the authors.  
 
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your  comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years r eceived reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, o r salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal . I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named  report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Endo scopic Ultrasound -guided Transmural Drainage fo r Subphrenic Abscess: Report of 
Two Cases and a Literature Review  
 
Version: 1 Date: 26 Nov 2017  
 
Reviewer: Joan B. Gornals  
 
Reviewer's report:  
 
Reviewer comments to the authors:  
 
The purpose of th is work, entitled 'Endoscopic Ultrasound -guided Transmural Drainage for 
Subphrenic Abscess: Report of Two Cases and a Literature Review.' is to describe a 2 cases from 
one center, and to describe a literature review  
 
 
Abstract and main text is well organize d and well -written, and the content is interesting. But 
some aspects are confusing, unclear or lacking. Lists of several issues with this paper:  
 
 
 
Several issues to comment:  
 
A. Major issues:  
 
- There is a concern in the case#1 regards the timing when dthe E US-TMD was performed. At 17 
days after surgery, plus 4 days of antibiotic, EUS -TD was selected as the drainage method. Was 
this an enough period of time (is less than 4 weeks) for getting a mature abscess wall? It was 
well checked by EUS -image examination?  This was an adherent or non -adherent collection to 
the GI wall? Please, all these questions should be well -explained in the text. Could this things 
change any of the technical aspects? type of balloon catheters? Change of any device? Change 
on the stents type or size?  
 
 
 
- Discussion:  
 
Please, after your experience a literature review, clarify if or give a more clear opinion, regarding 
if external drainage catheter are needed, in the same time of EUS -TMD.  
 
 
Please; review and add if it is true another case of abdominal abscess treted by using a 
lumenapposing metal stent. Alcaide N et al. EUS -guided drainage of liver abscess by using a 
lumen -apposing metal stent(with video). Gastrointest Endosc. 2013 Dec;78(6):941 -2; discussion 
942. doi: 10.1016/j.gie.2013.07.03 4 
 
 
B. Minor issues:  
 
-Case presentations, case#1, pag6, line 22 -32: 
 
Please, it is recommended change the word 'tunnel' to 'ostomy'; add endosonograhy guidance 
(plus fluoroscopic guidance); specify the diameter rage of the balloon catheter (8mm? -10mm?..), 
and the7 -Fr pigtail plastic stent length (in cm).  
 
 
-Case#2, pag 8, line 6 -7: please add the 7fr pigtail stent length and specify the balloon catheter 
size, for a better understanding of the technical aspects.  
 
 
-There were any technical changes between both cases?  
 
 
-Typographies: '7 -Fr double pigtail' or '7F double pigtail'. The same with '6 -Fr naso -abscess 
catheter' or '6 F naso -abscess'.  
 
 
- Discussion: Please, (at page 12, line over 52) consider adding a case of pneumothorax after a 
transesophageal drainage of a paraesophageal pancreatic cpseudocyts using a lumen -apposing 
metal stent (Gornals et al. Endoscopic ultrasound -guided transesophageal drainage of a 
mediastinal pancreatic pseudocyst using a novel lumen -apposing metal stent. Endoscopy. 
2012;44 Suppl 2 UCTN:E211 -2. doi: 10.1055/s -0032 -1309384)  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your co mments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your  comments to the authors.  
 
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your  comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years r eceived reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, o r salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal . I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named  report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant