Title: Evaluation of Double-Balloon Enteroscopy in the Management of Type 1 Small Bowel
Vascular Lesions (angioectasia): A Retrospective Cohort Study
Version: 4 Date: 10 Dec 2024
Reviewer:  Daniel Wild
Reviewer's report:
The authors have satisfactorily addressed the majority of my concerns and comments though I
still question the applicability of this study to a broader clinical context given the issues raised
previously.
The only additional points that I think still warrant further clarification are:
1) What this means, "In addition, untreated SBVL requiring additional endoscopic treatment in
first DBE were not included in our study."  Why were these pts excluded.  And if the SBVL
was "untreated" than why would it then require "additional endoscopic treatment."  And what
additional treatment were provided and when / how if not during their initial DBE.
2) Since they maintain that their was a strict protocol to always reach the ileum, it is still not clear
how this was defined during the DBE.  How did the endoscopist always confirm he / she reached
the ileum on antegrade exams?  Timing, fold or reduction counting, fluoro, mucosal appearance?
Or just the gestalt of an experienced endoscopist?  And the ileum is a long segment so did he /
she always stop as soon as he / she thought he / she was in the proximal ileum, mid ileum?
Title: Evaluation of Double-Balloon Enteroscopy in the Management of Type 1 Small Bowel
Vascular Lesions (angioectasia): A Retrospective Cohort Study
Version: 4 Date: 10 Dec 2024
Reviewer:  Daniel Wild
Reviewer's report:
The authors have satisfactorily addressed the majority of my concerns and comments though I
still question the applicability of this study to a broader clinical context given the issues raised
previously.
The only additional points that I think still warrant further clarification are:
1) What this means, "In addition, untreated SBVL requiring additional endoscopic treatment in
first DBE were not included in our study."  Why were these pts excluded.  And if the SBVL
was "untreated" than why would it then require "additional endoscopic treatment."  And what
additional treatment were provided and when / how if not during their initial DBE.
2) Since they maintain that their was a strict protocol to always reach the ileum, it is still not clear
how this was defined during the DBE.  How did the endoscopist always confirm he / she reached
the ileum on antegrade exams?  Timing, fold or reduction counting, fluoro, mucosal appearance?
Or just the gestalt of an experienced endoscopist?  And the ileum is a long segment so did he /
she always stop as soon as he / she thought he / she was in the proximal ileum, mid ileum?
Please review this paper.
user
Title: Evaluation of Double-Balloon Enteroscopy in the Management of Type 1 Small Bowel
Vascular Lesions (angioectasia): A Retrospective Cohort Study
Version: 4 Date: 10 Dec 2024
Reviewer:  Daniel Wild
Reviewer's report:
The authors have satisfactorily addressed the majority of my concerns and comments though I
still question the applicability of this study to a broader clinical context given the issues raised
previously.
The only additional points that I think still warrant further clarification are:
1) What this means, "In addition, untreated SBVL requiring additional endoscopic treatment in
first DBE were not included in our study."  Why were these pts excluded.  And if the SBVL
was "untreated" than why would it then require "additional endoscopic treatment."  And what
additional treatment were provided and when / how if not during their initial DBE.
2) Since they maintain that their was a strict protocol to always reach the ileum, it is still not clear
how this was defined during the DBE.  How did the endoscopist always confirm he / she reached
the ileum on antegrade exams?  Timing, fold or reduction counting, fluoro, mucosal appearance?
Or just the gestalt of an experienced endoscopist?  And the ileum is a long segment so did he /
she always stop as soon as he / she thought he / she was in the proximal ileum, mid ileum?
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