Title: Clinical outcomes of drug-coated balloons dilatation for benign esophageal stricture
Version: 2 Date: 14 Sep 2024
Reviewer's report:
In this study, DCB dilatation, typically used for coronary vascular disease, was innovatively
applied to the treatment of refractory benign esophageal stenosis. A single-arm, retrospective
study included 18 patients, revealing a clinical success rate of 84.2% for DCB dilatation.
However, several issues need to be addressed before considering publication. If these concerns
are adequately resolved, this reviewer believes that the contributions of this paper are significant
for the treatment of refractory benign esophageal stenosis.
1. Upper gastrointestinal endoscopy allows for scar dissection and dilation under direct
visualization, providing short-term symptom relief for esophageal strictures, which is a simpler
and safer approach. In comparison, the clinical significance of radiological DCB dilatation
appears limited. Further elaboration on the clinical significance of DCB dilatation is required.
2. Post-dilation indicators include stricture diameter and length, dysphagia scores, and stricture
indices. The images presented were taken a few days after DCB dilatation, and there is a lack of
long-term postoperative imaging data. Moreover, it remains unclear whether the dysphagia score
and the stenosis index correspond to the same time frame as the chest CT and esophagography.
3. The background section does not specifically address the types and effects of antiproliferative
drugs used in DCB balloons. While these drugs are known to inhibit endothelial cell
proliferation, there is insufficient literature supporting their effectiveness in treating esophageal
stenosis. If there is no distinct effect, the dilation efficacy of DCBs may not differ from that of
conventional balloon dilation. This aspect could be improved.
4. The article and table indicate a total of 18 patients; however, the methods section of the
abstract states, “From May 2020 to August 2023, 19 patients underwent DCB dilatation for
benign esophageal strictures.” Please verify the original data to rectify this discrepancy.
5. The conclusion of this study asserts that “DCBs dilatation can be a safe, effective, and
feasible treatment for benign esophageal strictures,” which contradicts the term “refractory
benign esophageal strictures” used in the title. Please align the terminology between the title
and the content.
6. The inclusion criteria specify that patients must have “failed in repeated push-type dilators or
balloon dilation,” implying that all included patients should have undergone at least one prior
dilation attempt. However, only 10 patients (52.6%) received non-DCB dilation, and 2 patients
underwent bougienage before DCB dilatation. Please provide clarification on this matter.
Title: Clinical outcomes of drug-coated balloons dilatation for benign esophageal stricture
Version: 2 Date: 14 Sep 2024
Reviewer's report:
In this study, DCB dilatation, typically used for coronary vascular disease, was innovatively
applied to the treatment of refractory benign esophageal stenosis. A single-arm, retrospective
study included 18 patients, revealing a clinical success rate of 84.2% for DCB dilatation.
However, several issues need to be addressed before considering publication. If these concerns
are adequately resolved, this reviewer believes that the contributions of this paper are significant
for the treatment of refractory benign esophageal stenosis.
1. Upper gastrointestinal endoscopy allows for scar dissection and dilation under direct
visualization, providing short-term symptom relief for esophageal strictures, which is a simpler
and safer approach. In comparison, the clinical significance of radiological DCB dilatation
appears limited. Further elaboration on the clinical significance of DCB dilatation is required.
2. Post-dilation indicators include stricture diameter and length, dysphagia scores, and stricture
indices. The images presented were taken a few days after DCB dilatation, and there is a lack of
long-term postoperative imaging data. Moreover, it remains unclear whether the dysphagia score
and the stenosis index correspond to the same time frame as the chest CT and esophagography.
3. The background section does not specifically address the types and effects of antiproliferative
drugs used in DCB balloons. While these drugs are known to inhibit endothelial cell
proliferation, there is insufficient literature supporting their effectiveness in treating esophageal
stenosis. If there is no distinct effect, the dilation efficacy of DCBs may not differ from that of
conventional balloon dilation. This aspect could be improved.
4. The article and table indicate a total of 18 patients; however, the methods section of the
abstract states, “From May 2020 to August 2023, 19 patients underwent DCB dilatation for
benign esophageal strictures.” Please verify the original data to rectify this discrepancy.
5. The conclusion of this study asserts that “DCBs dilatation can be a safe, effective, and
feasible treatment for benign esophageal strictures,” which contradicts the term “refractory
benign esophageal strictures” used in the title. Please align the terminology between the title
and the content.
6. The inclusion criteria specify that patients must have “failed in repeated push-type dilators or
balloon dilation,” implying that all included patients should have undergone at least one prior
dilation attempt. However, only 10 patients (52.6%) received non-DCB dilation, and 2 patients
underwent bougienage before DCB dilatation. Please provide clarification on this matter.
Please review this paper.
user
Title: Clinical outcomes of drug-coated balloons dilatation for benign esophageal stricture
Version: 2 Date: 14 Sep 2024
Reviewer's report:
In this study, DCB dilatation, typically used for coronary vascular disease, was innovatively
applied to the treatment of refractory benign esophageal stenosis. A single-arm, retrospective
study included 18 patients, revealing a clinical success rate of 84.2% for DCB dilatation.
However, several issues need to be addressed before considering publication. If these concerns
are adequately resolved, this reviewer believes that the contributions of this paper are significant
for the treatment of refractory benign esophageal stenosis.
1. Upper gastrointestinal endoscopy allows for scar dissection and dilation under direct
visualization, providing short-term symptom relief for esophageal strictures, which is a simpler
and safer approach. In comparison, the clinical significance of radiological DCB dilatation
appears limited. Further elaboration on the clinical significance of DCB dilatation is required.
2. Post-dilation indicators include stricture diameter and length, dysphagia scores, and stricture
indices. The images presented were taken a few days after DCB dilatation, and there is a lack of
long-term postoperative imaging data. Moreover, it remains unclear whether the dysphagia score
and the stenosis index correspond to the same time frame as the chest CT and esophagography.
3. The background section does not specifically address the types and effects of antiproliferative
drugs used in DCB balloons. While these drugs are known to inhibit endothelial cell
proliferation, there is insufficient literature supporting their effectiveness in treating esophageal
stenosis. If there is no distinct effect, the dilation efficacy of DCBs may not differ from that of
conventional balloon dilation. This aspect could be improved.
4. The article and table indicate a total of 18 patients; however, the methods section of the
abstract states, “From May 2020 to August 2023, 19 patients underwent DCB dilatation for
benign esophageal strictures.” Please verify the original data to rectify this discrepancy.
5. The conclusion of this study asserts that “DCBs dilatation can be a safe, effective, and
feasible treatment for benign esophageal strictures,” which contradicts the term “refractory
benign esophageal strictures” used in the title. Please align the terminology between the title
and the content.
6. The inclusion criteria specify that patients must have “failed in repeated push-type dilators or
balloon dilation,” implying that all included patients should have undergone at least one prior
dilation attempt. However, only 10 patients (52.6%) received non-DCB dilation, and 2 patients
underwent bougienage before DCB dilatation. Please provide clarification on this matter.
assistant