Reviewer ’s report  
 
Title:  Bowel obstruc tion associated with a feeding jejunostomy and its association to weight loss 
after thoracoscopic esophagectomy  
 
Version: 2 Date: 28 May 2019 
 
Reviewer:  Yasuhiro  Shirakawa  
 
Reviewer’s report:  
 
The present report is interesting f or the readers of "BMC Gastroenterology. However, I think this 
manuscript does not reach the enough level for publication in this condition. The author should 
add some comments and improve the manuscript for publication.  
 
 
 
Specific Points:  
 
1  
 
In the compar ison of BOFJ group and NBOFJ group, the author should state whether post -
operative adjuvant therapy was performed or not. I thought the postoperative weight change was 
considerably affected by the post -operative adjuvant therapy. So, the author should add a 
description in the discussion or result about the relationship with adjuvant therapy.  
 
 
2  
 
In the comparison of BOFJ group and NBOFJ group, the author should refer the presence of 
residual cancer after surgery and the cancer recurrence. If post -operative cancer remnants and 
cancer recurrence were observed, the patients would undergo the treated with chemotherapy 
and/or radiation. It seems that there is an influence on the postoperative weight change.  
 
 
3 
 
In this study, the author measured the length of the  abdominal axis, distance between the site of 
jejunostomy and midline, navel line, and xiphoid process line on CT scan. The author performed 
multivariate analysis on these parameters. The author should state how to define the cutoff value 
shown in table 3 in these analyses. Furthermore, in table3, the author defined the cutoff value of 
10% in one month after surgery and 15% in three months after surgery for postoperative weight 
loss. Authors should also show how to define them.  
 
 
4. 
In this study, the BOFJ g roup was defined by the cases that required surgery. Was this definition 
proper? The conservative care group after mild bowel obstruction could be considered as the 
NBOFJ group. However, there might be differences from the group that has not caused any 
intestinal obstruction in the postoperative course. The author should at least show how many 
cases have been treated conservatively in spite of postoperative bowel obstruction.  
 
 
5. 
 
In the "Diagnosis of BOFJ" in line 12 of page 8, there might be a spell miss. the author shouod 
correct "sing" to " sign". In addition, in figure 3, the author should correcrt "BOAFJ group" to 
"BOFJgroup" .  
 
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.  
 
Yes 
 
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 yo u 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 recommend additional statistical review  
 
Quality of written English  
Please in dicate 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, fees, funding, or salary from an 
organisation that may in any way gain or lose financially 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 tha t 
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, wri te '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 understand that my name will be include d 
on my report to the authors and, if the manuscript is accepted for 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 A ccess 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 editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title:  Bowel obstruc tion associated with a feeding jejunostomy and its association to weight loss 
after thoracoscopic esophagectomy  
 
Version: 2 Date: 28 May 2019 
 
Reviewer:  Yasuhiro  Shirakawa  
 
Reviewer’s report:  
 
The present report is interesting f or the readers of "BMC Gastroenterology. However, I think this 
manuscript does not reach the enough level for publication in this condition. The author should 
add some comments and improve the manuscript for publication.  
 
 
 
Specific Points:  
 
1  
 
In the compar ison of BOFJ group and NBOFJ group, the author should state whether post -
operative adjuvant therapy was performed or not. I thought the postoperative weight change was 
considerably affected by the post -operative adjuvant therapy. So, the author should add a 
description in the discussion or result about the relationship with adjuvant therapy.  
 
 
2  
 
In the comparison of BOFJ group and NBOFJ group, the author should refer the presence of 
residual cancer after surgery and the cancer recurrence. If post -operative cancer remnants and 
cancer recurrence were observed, the patients would undergo the treated with chemotherapy 
and/or radiation. It seems that there is an influence on the postoperative weight change.  
 
 
3 
 
In this study, the author measured the length of the  abdominal axis, distance between the site of 
jejunostomy and midline, navel line, and xiphoid process line on CT scan. The author performed 
multivariate analysis on these parameters. The author should state how to define the cutoff value 
shown in table 3 in these analyses. Furthermore, in table3, the author defined the cutoff value of 
10% in one month after surgery and 15% in three months after surgery for postoperative weight 
loss. Authors should also show how to define them.  
 
 
4. 
In this study, the BOFJ g roup was defined by the cases that required surgery. Was this definition 
proper? The conservative care group after mild bowel obstruction could be considered as the 
NBOFJ group. However, there might be differences from the group that has not caused any 
intestinal obstruction in the postoperative course. The author should at least show how many 
cases have been treated conservatively in spite of postoperative bowel obstruction.  
 
 
5. 
 
In the "Diagnosis of BOFJ" in line 12 of page 8, there might be a spell miss. the author shouod 
correct "sing" to " sign". In addition, in figure 3, the author should correcrt "BOAFJ group" to 
"BOFJgroup" .  
 
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.  
 
Yes 
 
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 yo u 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 recommend additional statistical review  
 
Quality of written English  
Please in dicate 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, fees, funding, or salary from an 
organisation that may in any way gain or lose financially 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 tha t 
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, wri te '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 understand that my name will be include d 
on my report to the authors and, if the manuscript is accepted for 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 A ccess 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 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:  Bowel obstruc tion associated with a feeding jejunostomy and its association to weight loss 
after thoracoscopic esophagectomy  
 
Version: 2 Date: 28 May 2019 
 
Reviewer:  Yasuhiro  Shirakawa  
 
Reviewer’s report:  
 
The present report is interesting f or the readers of "BMC Gastroenterology. However, I think this 
manuscript does not reach the enough level for publication in this condition. The author should 
add some comments and improve the manuscript for publication.  
 
 
 
Specific Points:  
 
1  
 
In the compar ison of BOFJ group and NBOFJ group, the author should state whether post -
operative adjuvant therapy was performed or not. I thought the postoperative weight change was 
considerably affected by the post -operative adjuvant therapy. So, the author should add a 
description in the discussion or result about the relationship with adjuvant therapy.  
 
 
2  
 
In the comparison of BOFJ group and NBOFJ group, the author should refer the presence of 
residual cancer after surgery and the cancer recurrence. If post -operative cancer remnants and 
cancer recurrence were observed, the patients would undergo the treated with chemotherapy 
and/or radiation. It seems that there is an influence on the postoperative weight change.  
 
 
3 
 
In this study, the author measured the length of the  abdominal axis, distance between the site of 
jejunostomy and midline, navel line, and xiphoid process line on CT scan. The author performed 
multivariate analysis on these parameters. The author should state how to define the cutoff value 
shown in table 3 in these analyses. Furthermore, in table3, the author defined the cutoff value of 
10% in one month after surgery and 15% in three months after surgery for postoperative weight 
loss. Authors should also show how to define them.  
 
 
4. 
In this study, the BOFJ g roup was defined by the cases that required surgery. Was this definition 
proper? The conservative care group after mild bowel obstruction could be considered as the 
NBOFJ group. However, there might be differences from the group that has not caused any 
intestinal obstruction in the postoperative course. The author should at least show how many 
cases have been treated conservatively in spite of postoperative bowel obstruction.  
 
 
5. 
 
In the "Diagnosis of BOFJ" in line 12 of page 8, there might be a spell miss. the author shouod 
correct "sing" to " sign". In addition, in figure 3, the author should correcrt "BOAFJ group" to 
"BOFJgroup" .  
 
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.  
 
Yes 
 
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 yo u 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 recommend additional statistical review  
 
Quality of written English  
Please in dicate 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, fees, funding, or salary from an 
organisation that may in any way gain or lose financially 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 tha t 
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, wri te '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 understand that my name will be include d 
on my report to the authors and, if the manuscript is accepted for 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 A ccess 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 editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant