Title: Outcomes of endoscopic submucosal dissection for gastroesophageal reflux disease
(ESD-G) for medication-refractory gastroesophageal reflux disease: 35 cases underwent ESD-
G including 15 cases followed more than 5 years.
Version: 4 Date: 21 Sep 2021
Reviewer:  Shiko Kuribayashi
Reviewer's report:
Authors did not answer my questions appropriately. I ask them one more time which should be
answered adequately.
Major comments
1. Authors answered that a sham treatment cannot be performed; however, I think that it can be
performed. Just endoscopy is performed without resection, which must be the sham treatment.
2. Since there are too many missing data, results are difficult to be evaluated. Impedance-pH
monitoring was performed in less than half of patients. In addition, long term effects of ESD-G
were evaluated in only less than half of patients, which is the primary outcome of this manuscript.
This limitation should be noted in the discussion section clearly.
3. Did you perform impedance-pH monitoring on PPI or off PPI? Moreover, did you perform
esophageal manometry before impedance-pH manometry? Furthermore, how did you locate
esophageal pH sensor without manometry if you did not perform esophageal manometry? How
was esophageal motility in enrolled patients if you perform esophageal manometry? Authors
should describe details about it. Authors did not answer this question at all.
4. What kinds of patients were enrolled in the study? Since impedance-pH monitoring
was performed, patients could be categorized as reflux esophagitis, true NERD, reflux
hypersensitivity or functional heartburn. In addition, were the outcomes of ESD-G among these
patients different? Authors did not answer this question appropriately.
5. If the strength of the study is long-term outcome, authors should focus on it. If authors want
to discuss both short-term and long-term effects, the relationship between short-term and long-
term should be discussed. Current form of the manuscript is not suitable. Authors’ answer was
not appropriate.
Title: Outcomes of endoscopic submucosal dissection for gastroesophageal reflux disease
(ESD-G) for medication-refractory gastroesophageal reflux disease: 35 cases underwent ESD-
G including 15 cases followed more than 5 years.
Version: 4 Date: 21 Sep 2021
Reviewer:  Shiko Kuribayashi
Reviewer's report:
Authors did not answer my questions appropriately. I ask them one more time which should be
answered adequately.
Major comments
1. Authors answered that a sham treatment cannot be performed; however, I think that it can be
performed. Just endoscopy is performed without resection, which must be the sham treatment.
2. Since there are too many missing data, results are difficult to be evaluated. Impedance-pH
monitoring was performed in less than half of patients. In addition, long term effects of ESD-G
were evaluated in only less than half of patients, which is the primary outcome of this manuscript.
This limitation should be noted in the discussion section clearly.
3. Did you perform impedance-pH monitoring on PPI or off PPI? Moreover, did you perform
esophageal manometry before impedance-pH manometry? Furthermore, how did you locate
esophageal pH sensor without manometry if you did not perform esophageal manometry? How
was esophageal motility in enrolled patients if you perform esophageal manometry? Authors
should describe details about it. Authors did not answer this question at all.
4. What kinds of patients were enrolled in the study? Since impedance-pH monitoring
was performed, patients could be categorized as reflux esophagitis, true NERD, reflux
hypersensitivity or functional heartburn. In addition, were the outcomes of ESD-G among these
patients different? Authors did not answer this question appropriately.
5. If the strength of the study is long-term outcome, authors should focus on it. If authors want
to discuss both short-term and long-term effects, the relationship between short-term and long-
term should be discussed. Current form of the manuscript is not suitable. Authors’ answer was
not appropriate.
Please review this paper.
user
Title: Outcomes of endoscopic submucosal dissection for gastroesophageal reflux disease
(ESD-G) for medication-refractory gastroesophageal reflux disease: 35 cases underwent ESD-
G including 15 cases followed more than 5 years.
Version: 4 Date: 21 Sep 2021
Reviewer:  Shiko Kuribayashi
Reviewer's report:
Authors did not answer my questions appropriately. I ask them one more time which should be
answered adequately.
Major comments
1. Authors answered that a sham treatment cannot be performed; however, I think that it can be
performed. Just endoscopy is performed without resection, which must be the sham treatment.
2. Since there are too many missing data, results are difficult to be evaluated. Impedance-pH
monitoring was performed in less than half of patients. In addition, long term effects of ESD-G
were evaluated in only less than half of patients, which is the primary outcome of this manuscript.
This limitation should be noted in the discussion section clearly.
3. Did you perform impedance-pH monitoring on PPI or off PPI? Moreover, did you perform
esophageal manometry before impedance-pH manometry? Furthermore, how did you locate
esophageal pH sensor without manometry if you did not perform esophageal manometry? How
was esophageal motility in enrolled patients if you perform esophageal manometry? Authors
should describe details about it. Authors did not answer this question at all.
4. What kinds of patients were enrolled in the study? Since impedance-pH monitoring
was performed, patients could be categorized as reflux esophagitis, true NERD, reflux
hypersensitivity or functional heartburn. In addition, were the outcomes of ESD-G among these
patients different? Authors did not answer this question appropriately.
5. If the strength of the study is long-term outcome, authors should focus on it. If authors want
to discuss both short-term and long-term effects, the relationship between short-term and long-
term should be discussed. Current form of the manuscript is not suitable. Authors’ answer was
not appropriate.
assistant