Reviewer's report
Title:Effectiveness of CO2-insufflated Endoscopic Submucosal Dissection with
the duodenal balloon occlusion method for early esophageal or gastric cancer
Version: 3Date:8 January 2012
Reviewer: Reginald V. Lord
Reviewer's report:
Review of Mori et al. “Effectiveness of CO2-insufflated endoscopic submucosal
dissection with the duodenal balloon occlusion method for early esophageal or
gastric cancer: a randomized prospective study”
The authors have performed a RCT of CO2 insufflation for endoscopic
submucosal dissection with an overtube allowing the CO2 to escape through the
mouth. In the study arm, a duodenal balloon for occlusion was used. This is the
first report on CO2 for esophageal and gastric ESD. In the control arm standard
insufflations was used without a duodenal balloon. Intestinal CO2 gas volume
measured by 3DCT before and after ESD was highly significantly lower in the
duodenal balloon group. Volume was reported as unchanged after balloon
occlusion but the post-therapy CT was performed the following day.
COMPULSORY REVISIONS
1. The chief limitation of this study is the lack of accuracy of CT for measuring
intestinal volume. More information should be provided regarding exactly how
these measurements were made by the radiology technicians. Were any of the
authors involved in making these measurements?
2. End tidal CO2 was lower in the balloon arm but pH levels were similar. Why
was measurement of end-tidal CO2 concluded at 2 hours even if the procedure
took longer than this to perform?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests.
Reviewer's report
Title:Effectiveness of CO2-insufflated Endoscopic Submucosal Dissection with
the duodenal balloon occlusion method for early esophageal or gastric cancer
Version: 3Date:8 January 2012
Reviewer: Reginald V. Lord
Reviewer's report:
Review of Mori et al. “Effectiveness of CO2-insufflated endoscopic submucosal
dissection with the duodenal balloon occlusion method for early esophageal or
gastric cancer: a randomized prospective study”
The authors have performed a RCT of CO2 insufflation for endoscopic
submucosal dissection with an overtube allowing the CO2 to escape through the
mouth. In the study arm, a duodenal balloon for occlusion was used. This is the
first report on CO2 for esophageal and gastric ESD. In the control arm standard
insufflations was used without a duodenal balloon. Intestinal CO2 gas volume
measured by 3DCT before and after ESD was highly significantly lower in the
duodenal balloon group. Volume was reported as unchanged after balloon
occlusion but the post-therapy CT was performed the following day.
COMPULSORY REVISIONS
1. The chief limitation of this study is the lack of accuracy of CT for measuring
intestinal volume. More information should be provided regarding exactly how
these measurements were made by the radiology technicians. Were any of the
authors involved in making these measurements?
2. End tidal CO2 was lower in the balloon arm but pH levels were similar. Why
was measurement of end-tidal CO2 concluded at 2 hours even if the procedure
took longer than this to perform?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Effectiveness of CO2-insufflated Endoscopic Submucosal Dissection with
the duodenal balloon occlusion method for early esophageal or gastric cancer
Version: 3Date:8 January 2012
Reviewer: Reginald V. Lord
Reviewer's report:
Review of Mori et al. “Effectiveness of CO2-insufflated endoscopic submucosal
dissection with the duodenal balloon occlusion method for early esophageal or
gastric cancer: a randomized prospective study”
The authors have performed a RCT of CO2 insufflation for endoscopic
submucosal dissection with an overtube allowing the CO2 to escape through the
mouth. In the study arm, a duodenal balloon for occlusion was used. This is the
first report on CO2 for esophageal and gastric ESD. In the control arm standard
insufflations was used without a duodenal balloon. Intestinal CO2 gas volume
measured by 3DCT before and after ESD was highly significantly lower in the
duodenal balloon group. Volume was reported as unchanged after balloon
occlusion but the post-therapy CT was performed the following day.
COMPULSORY REVISIONS
1. The chief limitation of this study is the lack of accuracy of CT for measuring
intestinal volume. More information should be provided regarding exactly how
these measurements were made by the radiology technicians. Were any of the
authors involved in making these measurements?
2. End tidal CO2 was lower in the balloon arm but pH levels were similar. Why
was measurement of end-tidal CO2 concluded at 2 hours even if the procedure
took longer than this to perform?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competing interests.
assistant