Reviewer ’s report  
 
Title: Stenting as a bridge to surgery for extra -colonic malignancy induced colorectal 
obstruction: preliminary experience  
 
Version: 0 Date: 23 Sep 2019  
 
Reviewer: Holger Schäffler  
 
Reviewer's report:  
 
Extra -colonic malignancies which lead to colonic obstruction are an important problem in the 
field of gastro enterology, however, studies which adress the non -surgical treatment are rare. The 
authors show in a retrospective cohort of patients, that the use of a self -expanding metal stent is a 
possible and very interesting treatment approach, since it can serve as  a "bridge to surgery". The 
authors have a case series of 9 patients and show a high rate of technical and surgical success 
rates.  
 
Since this is a very important field in interventional gastroenterology and studies in this field are 
rare, I read this man uscript with great interest.  
 
However, a few questions should be addressed:  
 
1) Why was the ISS (interval from stent to surgery) so different in the patients? The range is 
from 5 until 357 days. If the time is about a year, it is no more "BTS". Since the p atients have a 
high mortalitiy and morbidity, this aspect should be discussed.  
 
2) The authors state that 33 patients received SEMS for colorectal obstruction due to ECM. 
However, only 9 underent SEMS as a BTS. The high number of 33 patients is impressive , 
however, they do not play a role in the manuscript, the effect of SEMS as a BTS is only 
important for the 9 patients. I recommend to just discuss the 9 patients. Since it is a retrospective 
analysis, the manuscript should be classified as "Case series".  
 
3) P11, L20 -27: The authors state that pancreatic cancer is resistant to chemotherapies. Since this 
aspect is not completely right, the authors should re -write this sentences and also include 
literature to underscore their arguments.  
 
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 contro ls are required in your comments to the authors.  
 
No 
 
 
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 manuscript or would you recommend  an 
additional statistical review?  
If an additional statistical review is recommended, please specify 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:  
 
Needs some language corrections before being published  
 
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 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, 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 c an 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 websi te 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 name d report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Stenting as a bridge to surgery for extra -colonic malignancy induced colorectal 
obstruction: preliminary experience  
 
Version: 0 Date: 23 Sep 2019  
 
Reviewer: Holger Schäffler  
 
Reviewer's report:  
 
Extra -colonic malignancies which lead to colonic obstruction are an important problem in the 
field of gastro enterology, however, studies which adress the non -surgical treatment are rare. The 
authors show in a retrospective cohort of patients, that the use of a self -expanding metal stent is a 
possible and very interesting treatment approach, since it can serve as  a "bridge to surgery". The 
authors have a case series of 9 patients and show a high rate of technical and surgical success 
rates.  
 
Since this is a very important field in interventional gastroenterology and studies in this field are 
rare, I read this man uscript with great interest.  
 
However, a few questions should be addressed:  
 
1) Why was the ISS (interval from stent to surgery) so different in the patients? The range is 
from 5 until 357 days. If the time is about a year, it is no more "BTS". Since the p atients have a 
high mortalitiy and morbidity, this aspect should be discussed.  
 
2) The authors state that 33 patients received SEMS for colorectal obstruction due to ECM. 
However, only 9 underent SEMS as a BTS. The high number of 33 patients is impressive , 
however, they do not play a role in the manuscript, the effect of SEMS as a BTS is only 
important for the 9 patients. I recommend to just discuss the 9 patients. Since it is a retrospective 
analysis, the manuscript should be classified as "Case series".  
 
3) P11, L20 -27: The authors state that pancreatic cancer is resistant to chemotherapies. Since this 
aspect is not completely right, the authors should re -write this sentences and also include 
literature to underscore their arguments.  
 
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 contro ls are required in your comments to the authors.  
 
No 
 
 
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 manuscript or would you recommend  an 
additional statistical review?  
If an additional statistical review is recommended, please specify 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:  
 
Needs some language corrections before being published  
 
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 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, 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 c an 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 websi te 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 name d report can be in cluded as confidential comments 
to the editors, 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: Stenting as a bridge to surgery for extra -colonic malignancy induced colorectal 
obstruction: preliminary experience  
 
Version: 0 Date: 23 Sep 2019  
 
Reviewer: Holger Schäffler  
 
Reviewer's report:  
 
Extra -colonic malignancies which lead to colonic obstruction are an important problem in the 
field of gastro enterology, however, studies which adress the non -surgical treatment are rare. The 
authors show in a retrospective cohort of patients, that the use of a self -expanding metal stent is a 
possible and very interesting treatment approach, since it can serve as  a "bridge to surgery". The 
authors have a case series of 9 patients and show a high rate of technical and surgical success 
rates.  
 
Since this is a very important field in interventional gastroenterology and studies in this field are 
rare, I read this man uscript with great interest.  
 
However, a few questions should be addressed:  
 
1) Why was the ISS (interval from stent to surgery) so different in the patients? The range is 
from 5 until 357 days. If the time is about a year, it is no more "BTS". Since the p atients have a 
high mortalitiy and morbidity, this aspect should be discussed.  
 
2) The authors state that 33 patients received SEMS for colorectal obstruction due to ECM. 
However, only 9 underent SEMS as a BTS. The high number of 33 patients is impressive , 
however, they do not play a role in the manuscript, the effect of SEMS as a BTS is only 
important for the 9 patients. I recommend to just discuss the 9 patients. Since it is a retrospective 
analysis, the manuscript should be classified as "Case series".  
 
3) P11, L20 -27: The authors state that pancreatic cancer is resistant to chemotherapies. Since this 
aspect is not completely right, the authors should re -write this sentences and also include 
literature to underscore their arguments.  
 
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 contro ls are required in your comments to the authors.  
 
No 
 
 
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 manuscript or would you recommend  an 
additional statistical review?  
If an additional statistical review is recommended, please specify 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:  
 
Needs some language corrections before being published  
 
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 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, 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 c an 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 websi te 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 name d report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant