Title: Impact of the Body Mass Index on the Retention of the Anorectal Mucosa after Double-
stapled Ileal Pouch-anal Anastomosis for Ulcerative Colitis
Version: 4 Date: 21 Jan 2023
Reviewer's report:
Major problems:
#1:  In this study, anastomosis was performed with a 31 mm circular stapler in all patients. Is it
possible to insert a 31mm circular stapler into the anus of Japanese patients?
#2:  In Table 1, the authors conclude that male-to-female ratio was not a factor related to length of
the retained mucosa. In general, the surgical procedure such as the rectum are easier for women
than men because the pelvis is wider. We would like to know why there was no relevance in
this study.
#3:  The authors should add their considerations about what measures can be taken to reduce
length of the retained anorectal mucosa in patients with high BMI.
Minor problems:
#1:  We can well understand the result of longer retained mucosa on the anterior wall than on
the posterior wall.
Please describe in detail the cases in which retained mucosa more than 5 cm.
#2:  Consider adding items for disease duration and total steroid dose in Table 1.
Title: Impact of the Body Mass Index on the Retention of the Anorectal Mucosa after Double-
stapled Ileal Pouch-anal Anastomosis for Ulcerative Colitis
Version: 4 Date: 21 Jan 2023
Reviewer's report:
Major problems:
#1:  In this study, anastomosis was performed with a 31 mm circular stapler in all patients. Is it
possible to insert a 31mm circular stapler into the anus of Japanese patients?
#2:  In Table 1, the authors conclude that male-to-female ratio was not a factor related to length of
the retained mucosa. In general, the surgical procedure such as the rectum are easier for women
than men because the pelvis is wider. We would like to know why there was no relevance in
this study.
#3:  The authors should add their considerations about what measures can be taken to reduce
length of the retained anorectal mucosa in patients with high BMI.
Minor problems:
#1:  We can well understand the result of longer retained mucosa on the anterior wall than on
the posterior wall.
Please describe in detail the cases in which retained mucosa more than 5 cm.
#2:  Consider adding items for disease duration and total steroid dose in Table 1.
Please review this paper.
user
Title: Impact of the Body Mass Index on the Retention of the Anorectal Mucosa after Double-
stapled Ileal Pouch-anal Anastomosis for Ulcerative Colitis
Version: 4 Date: 21 Jan 2023
Reviewer's report:
Major problems:
#1:  In this study, anastomosis was performed with a 31 mm circular stapler in all patients. Is it
possible to insert a 31mm circular stapler into the anus of Japanese patients?
#2:  In Table 1, the authors conclude that male-to-female ratio was not a factor related to length of
the retained mucosa. In general, the surgical procedure such as the rectum are easier for women
than men because the pelvis is wider. We would like to know why there was no relevance in
this study.
#3:  The authors should add their considerations about what measures can be taken to reduce
length of the retained anorectal mucosa in patients with high BMI.
Minor problems:
#1:  We can well understand the result of longer retained mucosa on the anterior wall than on
the posterior wall.
Please describe in detail the cases in which retained mucosa more than 5 cm.
#2:  Consider adding items for disease duration and total steroid dose in Table 1.
assistant