Reviewer's report
Title:Risk Factors for Early and Delayed Post-Operative Bleeding after
Endoscopic Submucosal Dissection of Gastric Neoplasms, Including Patients
with Continued Use of Antithrombotic Agents
Version:2Date:23 July 2014
Reviewer: Atsushi Mitsunaga
Reviewer's report:
The detection of the risk factors that influence the bleeding after gastric ESD is
essential to clarify what is necessary to prevent the bleeding after the procedure
when we perform ESD for a patients using antithrombotic agents. The study of
this field is insufficient and the correspondence in the guideline for the
management of antithrombotic agents in gastric ESD is different in each country
and each facility of our country that is pointed out by the authors. In addition, the
opinion that was provided in the past reports about the bleeding after gastric ESD
in a patient using LDA is still controversial.
This study gives one of the suggestion about this point. Especially the result that
LDA does not influence the bleeding after gastric ESD is a useful knowledge
because we can perform ESD with continued LDA in the high-risk patients of
thromboembolism.
Revise points
major
1. On the 3th line of the 7th page authors divided the patients into two groups for
of thromboembolism, I think it is necessary to make the standard of higher- and
lower-risk clear.
2. I think the authors should discuss about the conclusion that is "a maximum
diameter of specimen size has an influence on the bleeding within 5 days after
ESD, and HR or CKD on HD has an influence on the subsequent bleeding" with
regarding to ulcer healing after ESD.
minor
1. I cannot understand the meaning of the 13th line of the 13 page "the patient
age threshold was 40mm".
2. This study was retrospective design as the authors mentioned on the 10th line
of the 17th page, it should be mentioned in Methods at first.
Reviewer's report
Title:Risk Factors for Early and Delayed Post-Operative Bleeding after
Endoscopic Submucosal Dissection of Gastric Neoplasms, Including Patients
with Continued Use of Antithrombotic Agents
Version:2Date:23 July 2014
Reviewer: Atsushi Mitsunaga
Reviewer's report:
The detection of the risk factors that influence the bleeding after gastric ESD is
essential to clarify what is necessary to prevent the bleeding after the procedure
when we perform ESD for a patients using antithrombotic agents. The study of
this field is insufficient and the correspondence in the guideline for the
management of antithrombotic agents in gastric ESD is different in each country
and each facility of our country that is pointed out by the authors. In addition, the
opinion that was provided in the past reports about the bleeding after gastric ESD
in a patient using LDA is still controversial.
This study gives one of the suggestion about this point. Especially the result that
LDA does not influence the bleeding after gastric ESD is a useful knowledge
because we can perform ESD with continued LDA in the high-risk patients of
thromboembolism.
Revise points
major
1. On the 3th line of the 7th page authors divided the patients into two groups for
of thromboembolism, I think it is necessary to make the standard of higher- and
lower-risk clear.
2. I think the authors should discuss about the conclusion that is "a maximum
diameter of specimen size has an influence on the bleeding within 5 days after
ESD, and HR or CKD on HD has an influence on the subsequent bleeding" with
regarding to ulcer healing after ESD.
minor
1. I cannot understand the meaning of the 13th line of the 13 page "the patient
age threshold was 40mm".
2. This study was retrospective design as the authors mentioned on the 10th line
of the 17th page, it should be mentioned in Methods at first.
Please review this paper.
user
Reviewer's report
Title:Risk Factors for Early and Delayed Post-Operative Bleeding after
Endoscopic Submucosal Dissection of Gastric Neoplasms, Including Patients
with Continued Use of Antithrombotic Agents
Version:2Date:23 July 2014
Reviewer: Atsushi Mitsunaga
Reviewer's report:
The detection of the risk factors that influence the bleeding after gastric ESD is
essential to clarify what is necessary to prevent the bleeding after the procedure
when we perform ESD for a patients using antithrombotic agents. The study of
this field is insufficient and the correspondence in the guideline for the
management of antithrombotic agents in gastric ESD is different in each country
and each facility of our country that is pointed out by the authors. In addition, the
opinion that was provided in the past reports about the bleeding after gastric ESD
in a patient using LDA is still controversial.
This study gives one of the suggestion about this point. Especially the result that
LDA does not influence the bleeding after gastric ESD is a useful knowledge
because we can perform ESD with continued LDA in the high-risk patients of
thromboembolism.
Revise points
major
1. On the 3th line of the 7th page authors divided the patients into two groups for
of thromboembolism, I think it is necessary to make the standard of higher- and
lower-risk clear.
2. I think the authors should discuss about the conclusion that is "a maximum
diameter of specimen size has an influence on the bleeding within 5 days after
ESD, and HR or CKD on HD has an influence on the subsequent bleeding" with
regarding to ulcer healing after ESD.
minor
1. I cannot understand the meaning of the 13th line of the 13 page "the patient
age threshold was 40mm".
2. This study was retrospective design as the authors mentioned on the 10th line
of the 17th page, it should be mentioned in Methods at first.
assistant