Title: Endoscopic injection sclerotherapy for treating recurrent bleeding of small bowel
angioectasias
Version: 0 Date: 25 Nov 2022
Reviewer:  Jean-christophe Saurin
Reviewer's report:
This is a retrospective analysis of 61 patients with small bowel angiodysplasie treated by
aetoxysclerol injections (35) or by usual care (no endoscopic treatment, and in fact refusal of
endoscopic treatment, 31). This paper ins of rea l interest for the gastroenterological community,
as it present interesting data of treatment and FU using a very common treatment of SBAD in
experienced teams, but a treatment that has been very poorly validated in previous literature.
Limitation : Control group were older patients , retrospective study, large number of excluded
patients , so  that the positive effect observed with the injection process is exposed to multiple
bias, to be clarified in the discussion.
Table 1 : more characteristics of these patients in control and treatment group should be added
to this table : transfusion before admission and number of SB lesions (as both represent risk
factors for rebleeding), severe comorbidities (cardiopathy, renal insufficiency, cancer) : we need
to know how both groups were comparable before management, to clarify the multiple possible
bias .
Table 2 : it is not clear whether readmissions were because of new bleeding episodes or other
reasons
Figure 1 shows a very small angiodysplasie that would be classified as P1 in the relevance
classification for capsule endoscopy. I think that this is not the image to show in a paper dealing
with endoscopic treatment of SM AD, maybe the authors could present a more relevant lesion
(larger, bleeding)
As stated by the authors in the discussion, ther is a need for a prospective randomized study to
prouve the efficacy of any endoscopic treatment of SBAD against standard care.
Title: Endoscopic injection sclerotherapy for treating recurrent bleeding of small bowel
angioectasias
Version: 0 Date: 25 Nov 2022
Reviewer:  Jean-christophe Saurin
Reviewer's report:
This is a retrospective analysis of 61 patients with small bowel angiodysplasie treated by
aetoxysclerol injections (35) or by usual care (no endoscopic treatment, and in fact refusal of
endoscopic treatment, 31). This paper ins of rea l interest for the gastroenterological community,
as it present interesting data of treatment and FU using a very common treatment of SBAD in
experienced teams, but a treatment that has been very poorly validated in previous literature.
Limitation : Control group were older patients , retrospective study, large number of excluded
patients , so  that the positive effect observed with the injection process is exposed to multiple
bias, to be clarified in the discussion.
Table 1 : more characteristics of these patients in control and treatment group should be added
to this table : transfusion before admission and number of SB lesions (as both represent risk
factors for rebleeding), severe comorbidities (cardiopathy, renal insufficiency, cancer) : we need
to know how both groups were comparable before management, to clarify the multiple possible
bias .
Table 2 : it is not clear whether readmissions were because of new bleeding episodes or other
reasons
Figure 1 shows a very small angiodysplasie that would be classified as P1 in the relevance
classification for capsule endoscopy. I think that this is not the image to show in a paper dealing
with endoscopic treatment of SM AD, maybe the authors could present a more relevant lesion
(larger, bleeding)
As stated by the authors in the discussion, ther is a need for a prospective randomized study to
prouve the efficacy of any endoscopic treatment of SBAD against standard care.
Please review this paper.
user
Title: Endoscopic injection sclerotherapy for treating recurrent bleeding of small bowel
angioectasias
Version: 0 Date: 25 Nov 2022
Reviewer:  Jean-christophe Saurin
Reviewer's report:
This is a retrospective analysis of 61 patients with small bowel angiodysplasie treated by
aetoxysclerol injections (35) or by usual care (no endoscopic treatment, and in fact refusal of
endoscopic treatment, 31). This paper ins of rea l interest for the gastroenterological community,
as it present interesting data of treatment and FU using a very common treatment of SBAD in
experienced teams, but a treatment that has been very poorly validated in previous literature.
Limitation : Control group were older patients , retrospective study, large number of excluded
patients , so  that the positive effect observed with the injection process is exposed to multiple
bias, to be clarified in the discussion.
Table 1 : more characteristics of these patients in control and treatment group should be added
to this table : transfusion before admission and number of SB lesions (as both represent risk
factors for rebleeding), severe comorbidities (cardiopathy, renal insufficiency, cancer) : we need
to know how both groups were comparable before management, to clarify the multiple possible
bias .
Table 2 : it is not clear whether readmissions were because of new bleeding episodes or other
reasons
Figure 1 shows a very small angiodysplasie that would be classified as P1 in the relevance
classification for capsule endoscopy. I think that this is not the image to show in a paper dealing
with endoscopic treatment of SM AD, maybe the authors could present a more relevant lesion
(larger, bleeding)
As stated by the authors in the discussion, ther is a need for a prospective randomized study to
prouve the efficacy of any endoscopic treatment of SBAD against standard care.
assistant