Title: Manuscript Title: Comparative study on different endoscopic submucosal dissection
techniques for the treatment of superficial esophageal cancer and precancerous lesions
Version: 2 Date: 19 Dec 2024
Reviewer's report:
The manuscript provides some evidences about endoscopic submucosal dissection techniques
for superficial esophageal neoplasms. The authors could demonstrate that ESD-C has advantages
over ESTD and ESD in terms of operative time and resection speed. While I agree with
usefulness of the ESD-C technique in esophageal ESD, there are some concerns which are
described below. I hope that my comments are useful for the improvement of the article. 
Specific Comments
1. How did the endoscopists choose each ESD technique? The authors described “the selection of
endoscopic treatment modalities influenced by the procedural habits of the operating physicians
and the characteristics of the lesions” in Discussion section. Please add the detailed description
of the indication of each technique, especially about the characteristics of the lesions.
2. Each technique was used in the different periods? If so, is there any impact of learning curve
for study outcomes?
3. This is related to the previous query. As the authors described in Discussion section, there is
a selection vias which has some impact for study results. Please add the multivariate analysis
about operative time, and resection speed.
4. Did the operators use no traction method such as clip with line technique?
5. Please add the description about lesion size and morphology in Table 2.
6. Was the study aim to evaluate and compare the usefulness of different ESD techniques? Why
didn’t the multivariate analysis shown in Table 9 include ESD methodologies (ESD/ESTD/ESD-
C) as an explanatory variable?
Title: Manuscript Title: Comparative study on different endoscopic submucosal dissection
techniques for the treatment of superficial esophageal cancer and precancerous lesions
Version: 2 Date: 19 Dec 2024
Reviewer's report:
The manuscript provides some evidences about endoscopic submucosal dissection techniques
for superficial esophageal neoplasms. The authors could demonstrate that ESD-C has advantages
over ESTD and ESD in terms of operative time and resection speed. While I agree with
usefulness of the ESD-C technique in esophageal ESD, there are some concerns which are
described below. I hope that my comments are useful for the improvement of the article. 
Specific Comments
1. How did the endoscopists choose each ESD technique? The authors described “the selection of
endoscopic treatment modalities influenced by the procedural habits of the operating physicians
and the characteristics of the lesions” in Discussion section. Please add the detailed description
of the indication of each technique, especially about the characteristics of the lesions.
2. Each technique was used in the different periods? If so, is there any impact of learning curve
for study outcomes?
3. This is related to the previous query. As the authors described in Discussion section, there is
a selection vias which has some impact for study results. Please add the multivariate analysis
about operative time, and resection speed.
4. Did the operators use no traction method such as clip with line technique?
5. Please add the description about lesion size and morphology in Table 2.
6. Was the study aim to evaluate and compare the usefulness of different ESD techniques? Why
didn’t the multivariate analysis shown in Table 9 include ESD methodologies (ESD/ESTD/ESD-
C) as an explanatory variable?
Please review this paper.
user
Title: Manuscript Title: Comparative study on different endoscopic submucosal dissection
techniques for the treatment of superficial esophageal cancer and precancerous lesions
Version: 2 Date: 19 Dec 2024
Reviewer's report:
The manuscript provides some evidences about endoscopic submucosal dissection techniques
for superficial esophageal neoplasms. The authors could demonstrate that ESD-C has advantages
over ESTD and ESD in terms of operative time and resection speed. While I agree with
usefulness of the ESD-C technique in esophageal ESD, there are some concerns which are
described below. I hope that my comments are useful for the improvement of the article. 
Specific Comments
1. How did the endoscopists choose each ESD technique? The authors described “the selection of
endoscopic treatment modalities influenced by the procedural habits of the operating physicians
and the characteristics of the lesions” in Discussion section. Please add the detailed description
of the indication of each technique, especially about the characteristics of the lesions.
2. Each technique was used in the different periods? If so, is there any impact of learning curve
for study outcomes?
3. This is related to the previous query. As the authors described in Discussion section, there is
a selection vias which has some impact for study results. Please add the multivariate analysis
about operative time, and resection speed.
4. Did the operators use no traction method such as clip with line technique?
5. Please add the description about lesion size and morphology in Table 2.
6. Was the study aim to evaluate and compare the usefulness of different ESD techniques? Why
didn’t the multivariate analysis shown in Table 9 include ESD methodologies (ESD/ESTD/ESD-
C) as an explanatory variable?
assistant