Reviewer ’s report  
 
Title: Complications of Enterotomy and Related Risk Factor A nalysis of Very Early Onset  
Inflammatory Bowel Disease with Interleukin -10 Signalling Deficiency: A Single -Centre  
Retrospective Analysis  
 
Version: 2 Date: 09 Oct 2019  
 
Reviewer: Jung Ok Shim  
 
Reviewer's report:  
 
This is a relatively large scaled study in this research field about the enterotomy in children with 
VEOIBD.  
 
 
1. It would be better to describe whether genotypes of 22 patients were pathogenic variants or 
included variants of unknown significance.  
 
2. Please define the medical management in result 1 and table 1; did they mean 'before 
enterotomy' or 'throughout the study period'?  
How many patients experienced enterotomy after HSCT? Did you mean ten patients underwent 
HSCT before enterotomy (result 1 and table 1) and another 7 patients received HSCT after 
enterotomy (from result 5. follow -up)? How many patients among those 7 patients underwent 
repeated HSCT?  
In previous studies, HSCT showed a high cure rate. If 45% of patients underwent enterotomy 
despite HSCT, this result is quite different from other studies. Please discuss about the result.  
I understand that 7 patie nts experienced HSCT despite enterostomy. Please describe the time 
interval between enterotomy and HSCT.  
 
3. You may analyze the outcome by medical management before enterotomy, such as; a group 
with HSCT vs without HSCT; a group with biologics vs without b iologics.  
 
4. You can give more information about the clinical characteristics such as disease behaviors, 
locations, or type. They can be the important risk factors and outcome parameters. You may 
analyze the results according to the disease type, such as p enetrating/fistulous vs inflammatory 
type.  
It would be better to describe the status of mucosal inflammation and/or mucosal healing with 
basal and follow -up endoscopy and/or fecal calprotectin, if possible.  
 
5. In result 3, improvement of growth parameters at two time points might be due to other 
medical managements after enterotomy, such as biologics or HSCT. You should analyze these 
factors including time interval (follow -up periods) and other managements (including medicine -
free period after surgery) to e valuate the effect of enterotomy on growth because biologics and 
HSCT have shown good results in catch -up growth or relatively high remission rate.  
 
6. Can we know the rate of enterostomy closure and average time interval of it? This can be one 
of the outco mes and give additional information about the prognosis.  
 
- at line 6 in page 6; Please insert "median" and "interquartile range (IQR)" in the statement of 
"...12.0 months [5.0, 27.3]".  
 
- Please modify the title of tables so that they contain information i ndependently; for example, 
'Demographic characteristics of children with VEOIBD with IL10R deficiency'  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments 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.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
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.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Accep table  
 
 
 
 
 
 
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received 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 t hat 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, or 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 revi ew 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 included 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: Complications of Enterotomy and Related Risk Factor A nalysis of Very Early Onset  
Inflammatory Bowel Disease with Interleukin -10 Signalling Deficiency: A Single -Centre  
Retrospective Analysis  
 
Version: 2 Date: 09 Oct 2019  
 
Reviewer: Jung Ok Shim  
 
Reviewer's report:  
 
This is a relatively large scaled study in this research field about the enterotomy in children with 
VEOIBD.  
 
 
1. It would be better to describe whether genotypes of 22 patients were pathogenic variants or 
included variants of unknown significance.  
 
2. Please define the medical management in result 1 and table 1; did they mean 'before 
enterotomy' or 'throughout the study period'?  
How many patients experienced enterotomy after HSCT? Did you mean ten patients underwent 
HSCT before enterotomy (result 1 and table 1) and another 7 patients received HSCT after 
enterotomy (from result 5. follow -up)? How many patients among those 7 patients underwent 
repeated HSCT?  
In previous studies, HSCT showed a high cure rate. If 45% of patients underwent enterotomy 
despite HSCT, this result is quite different from other studies. Please discuss about the result.  
I understand that 7 patie nts experienced HSCT despite enterostomy. Please describe the time 
interval between enterotomy and HSCT.  
 
3. You may analyze the outcome by medical management before enterotomy, such as; a group 
with HSCT vs without HSCT; a group with biologics vs without b iologics.  
 
4. You can give more information about the clinical characteristics such as disease behaviors, 
locations, or type. They can be the important risk factors and outcome parameters. You may 
analyze the results according to the disease type, such as p enetrating/fistulous vs inflammatory 
type.  
It would be better to describe the status of mucosal inflammation and/or mucosal healing with 
basal and follow -up endoscopy and/or fecal calprotectin, if possible.  
 
5. In result 3, improvement of growth parameters at two time points might be due to other 
medical managements after enterotomy, such as biologics or HSCT. You should analyze these 
factors including time interval (follow -up periods) and other managements (including medicine -
free period after surgery) to e valuate the effect of enterotomy on growth because biologics and 
HSCT have shown good results in catch -up growth or relatively high remission rate.  
 
6. Can we know the rate of enterostomy closure and average time interval of it? This can be one 
of the outco mes and give additional information about the prognosis.  
 
- at line 6 in page 6; Please insert "median" and "interquartile range (IQR)" in the statement of 
"...12.0 months [5.0, 27.3]".  
 
- Please modify the title of tables so that they contain information i ndependently; for example, 
'Demographic characteristics of children with VEOIBD with IL10R deficiency'  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments 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.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
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.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Accep table  
 
 
 
 
 
 
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received 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 t hat 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, or 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 revi ew 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 included 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: Complications of Enterotomy and Related Risk Factor A nalysis of Very Early Onset  
Inflammatory Bowel Disease with Interleukin -10 Signalling Deficiency: A Single -Centre  
Retrospective Analysis  
 
Version: 2 Date: 09 Oct 2019  
 
Reviewer: Jung Ok Shim  
 
Reviewer's report:  
 
This is a relatively large scaled study in this research field about the enterotomy in children with 
VEOIBD.  
 
 
1. It would be better to describe whether genotypes of 22 patients were pathogenic variants or 
included variants of unknown significance.  
 
2. Please define the medical management in result 1 and table 1; did they mean 'before 
enterotomy' or 'throughout the study period'?  
How many patients experienced enterotomy after HSCT? Did you mean ten patients underwent 
HSCT before enterotomy (result 1 and table 1) and another 7 patients received HSCT after 
enterotomy (from result 5. follow -up)? How many patients among those 7 patients underwent 
repeated HSCT?  
In previous studies, HSCT showed a high cure rate. If 45% of patients underwent enterotomy 
despite HSCT, this result is quite different from other studies. Please discuss about the result.  
I understand that 7 patie nts experienced HSCT despite enterostomy. Please describe the time 
interval between enterotomy and HSCT.  
 
3. You may analyze the outcome by medical management before enterotomy, such as; a group 
with HSCT vs without HSCT; a group with biologics vs without b iologics.  
 
4. You can give more information about the clinical characteristics such as disease behaviors, 
locations, or type. They can be the important risk factors and outcome parameters. You may 
analyze the results according to the disease type, such as p enetrating/fistulous vs inflammatory 
type.  
It would be better to describe the status of mucosal inflammation and/or mucosal healing with 
basal and follow -up endoscopy and/or fecal calprotectin, if possible.  
 
5. In result 3, improvement of growth parameters at two time points might be due to other 
medical managements after enterotomy, such as biologics or HSCT. You should analyze these 
factors including time interval (follow -up periods) and other managements (including medicine -
free period after surgery) to e valuate the effect of enterotomy on growth because biologics and 
HSCT have shown good results in catch -up growth or relatively high remission rate.  
 
6. Can we know the rate of enterostomy closure and average time interval of it? This can be one 
of the outco mes and give additional information about the prognosis.  
 
- at line 6 in page 6; Please insert "median" and "interquartile range (IQR)" in the statement of 
"...12.0 months [5.0, 27.3]".  
 
- Please modify the title of tables so that they contain information i ndependently; for example, 
'Demographic characteristics of children with VEOIBD with IL10R deficiency'  
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments 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.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
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.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Accep table  
 
 
 
 
 
 
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received 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 t hat 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, or 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 revi ew 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 included as  confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant