Title: Over-the-scope clip-assisted endoscopic full-thickness resection has potential to treat
complex nonampullary duodenal lesions: a single-center case series
Version: 0 Date: 19 Jul 2021
Reviewer's report:
The authors reported the efficacy of OTSC-assisted EFTR for the treatment of duodenal
superficial neoplasms. Most important advantage of this procedure is safety compared with other
procedures (e.g., ESD). To achieve the therapeutic strategies for duodenal lesions, accumulation
of the cases are important. This manuscript will be improved after corresponds to following
revisions.
Major comments:
1. Method section: About the definition of R0 resection. Describe how treat the cases with lateral
margin cannot be determined because of coagulation artefacts.
2. Result section: Add the information about the presence of preoperative biopsy in the Table.
3. The concept of OTSC-assisted ETFR has been published in previous reports (e.g., EMRO,
reported by Tashima et al., doi: 10.1055/a-1374-6141). The authors should discuss the
differences of the procedures between the present study and previous reports.
4. As the authors described in the text, most important limitation is the size of target lesion.
Salvage endoscopic treatment for residual lesion may be considerably difficult, because the
half of OTSC was retained in the place. Operators should avoid the margin positive resection.
Therefore I think it is premature to apply OTSC-assisted EFTR into lesions larger than 10 mm.
Title: Over-the-scope clip-assisted endoscopic full-thickness resection has potential to treat
complex nonampullary duodenal lesions: a single-center case series
Version: 0 Date: 19 Jul 2021
Reviewer's report:
The authors reported the efficacy of OTSC-assisted EFTR for the treatment of duodenal
superficial neoplasms. Most important advantage of this procedure is safety compared with other
procedures (e.g., ESD). To achieve the therapeutic strategies for duodenal lesions, accumulation
of the cases are important. This manuscript will be improved after corresponds to following
revisions.
Major comments:
1. Method section: About the definition of R0 resection. Describe how treat the cases with lateral
margin cannot be determined because of coagulation artefacts.
2. Result section: Add the information about the presence of preoperative biopsy in the Table.
3. The concept of OTSC-assisted ETFR has been published in previous reports (e.g., EMRO,
reported by Tashima et al., doi: 10.1055/a-1374-6141). The authors should discuss the
differences of the procedures between the present study and previous reports.
4. As the authors described in the text, most important limitation is the size of target lesion.
Salvage endoscopic treatment for residual lesion may be considerably difficult, because the
half of OTSC was retained in the place. Operators should avoid the margin positive resection.
Therefore I think it is premature to apply OTSC-assisted EFTR into lesions larger than 10 mm.
Please review this paper.
user
Title: Over-the-scope clip-assisted endoscopic full-thickness resection has potential to treat
complex nonampullary duodenal lesions: a single-center case series
Version: 0 Date: 19 Jul 2021
Reviewer's report:
The authors reported the efficacy of OTSC-assisted EFTR for the treatment of duodenal
superficial neoplasms. Most important advantage of this procedure is safety compared with other
procedures (e.g., ESD). To achieve the therapeutic strategies for duodenal lesions, accumulation
of the cases are important. This manuscript will be improved after corresponds to following
revisions.
Major comments:
1. Method section: About the definition of R0 resection. Describe how treat the cases with lateral
margin cannot be determined because of coagulation artefacts.
2. Result section: Add the information about the presence of preoperative biopsy in the Table.
3. The concept of OTSC-assisted ETFR has been published in previous reports (e.g., EMRO,
reported by Tashima et al., doi: 10.1055/a-1374-6141). The authors should discuss the
differences of the procedures between the present study and previous reports.
4. As the authors described in the text, most important limitation is the size of target lesion.
Salvage endoscopic treatment for residual lesion may be considerably difficult, because the
half of OTSC was retained in the place. Operators should avoid the margin positive resection.
Therefore I think it is premature to apply OTSC-assisted EFTR into lesions larger than 10 mm.
assistant