Reviewer's report
Title:A randomized controlled trial of endoscopic steroid injection for prophylaxis
of esophageal stenoses after extensive endoscopic submucosal dissection
Version:1Date:26 October 2014
Reviewer: mate knabe
Reviewer's report:
In the present manuscript the authors analyze the prophylactic effect of local
steroid injection, following extensive endoscopic submucosal dissection in the
esophagus. The main objective was to investigate the development of
esophageal stenosis with or without this prophylactic treatment. The study was
performed as a randomized controlled trial on 32 patients. In summary the
frequency of strictures was not significantly different between the two groups, but
the number of dilatation sessions required was significantly less in the steroid
group. Therefore, they concluded that prophylactic steroid treatment can reduce
the severity of strictures after extensive ESD in the esophagus.
The present study is well written and the study design was suitable to answer the
question, although the sample size was too small to answer some of the main
objectives.
There are some major compulsory points I would like to mention.
1) Pech Oliver et al recently published in Gastroenterology a study with over
1000 patients which proved that endoscopic mucosal resection is a safe
procedure with a very high rate of complete remission. Rates of esophageal
stenosis are much lower after EMR than after extensive ESD. Moreover this,
there was only one perforation in the whole study-population. The question is:
why perform ESD with risk for consecutive esophageal stenosis and the need of
dilatation, instead of using EMR? Please discuss these facts in your manuscript.
2) In table number 2 there are 3 carcinomas with deeper submucosal invasion
(sm2). These patients have a relevant risk to develop lymphoid metastasis. Why
wasn’t surgery performed? Please comment on this.
No minor comments
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:A randomized controlled trial of endoscopic steroid injection for prophylaxis
of esophageal stenoses after extensive endoscopic submucosal dissection
Version:1Date:26 October 2014
Reviewer: mate knabe
Reviewer's report:
In the present manuscript the authors analyze the prophylactic effect of local
steroid injection, following extensive endoscopic submucosal dissection in the
esophagus. The main objective was to investigate the development of
esophageal stenosis with or without this prophylactic treatment. The study was
performed as a randomized controlled trial on 32 patients. In summary the
frequency of strictures was not significantly different between the two groups, but
the number of dilatation sessions required was significantly less in the steroid
group. Therefore, they concluded that prophylactic steroid treatment can reduce
the severity of strictures after extensive ESD in the esophagus.
The present study is well written and the study design was suitable to answer the
question, although the sample size was too small to answer some of the main
objectives.
There are some major compulsory points I would like to mention.
1) Pech Oliver et al recently published in Gastroenterology a study with over
1000 patients which proved that endoscopic mucosal resection is a safe
procedure with a very high rate of complete remission. Rates of esophageal
stenosis are much lower after EMR than after extensive ESD. Moreover this,
there was only one perforation in the whole study-population. The question is:
why perform ESD with risk for consecutive esophageal stenosis and the need of
dilatation, instead of using EMR? Please discuss these facts in your manuscript.
2) In table number 2 there are 3 carcinomas with deeper submucosal invasion
(sm2). These patients have a relevant risk to develop lymphoid metastasis. Why
wasn’t surgery performed? Please comment on this.
No minor comments
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:A randomized controlled trial of endoscopic steroid injection for prophylaxis
of esophageal stenoses after extensive endoscopic submucosal dissection
Version:1Date:26 October 2014
Reviewer: mate knabe
Reviewer's report:
In the present manuscript the authors analyze the prophylactic effect of local
steroid injection, following extensive endoscopic submucosal dissection in the
esophagus. The main objective was to investigate the development of
esophageal stenosis with or without this prophylactic treatment. The study was
performed as a randomized controlled trial on 32 patients. In summary the
frequency of strictures was not significantly different between the two groups, but
the number of dilatation sessions required was significantly less in the steroid
group. Therefore, they concluded that prophylactic steroid treatment can reduce
the severity of strictures after extensive ESD in the esophagus.
The present study is well written and the study design was suitable to answer the
question, although the sample size was too small to answer some of the main
objectives.
There are some major compulsory points I would like to mention.
1) Pech Oliver et al recently published in Gastroenterology a study with over
1000 patients which proved that endoscopic mucosal resection is a safe
procedure with a very high rate of complete remission. Rates of esophageal
stenosis are much lower after EMR than after extensive ESD. Moreover this,
there was only one perforation in the whole study-population. The question is:
why perform ESD with risk for consecutive esophageal stenosis and the need of
dilatation, instead of using EMR? Please discuss these facts in your manuscript.
2) In table number 2 there are 3 carcinomas with deeper submucosal invasion
(sm2). These patients have a relevant risk to develop lymphoid metastasis. Why
wasn’t surgery performed? Please comment on this.
No minor comments
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests
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