Title: Underwater endoscopic mucosal resection for rectal neuroendocrine tumors (with videos):
a single center retrospective study
Version: 2 Date: 22 Mar 2022
Reviewer's report:
Shi H, et al. investigated a single center retrospective comparative study of underwater
endoscopic mucosal resection (UEMR) and endoscopic submucosal dissection (ESD) for rectal
neuroendocrine tumors (NETs) #10 mm. Their results revealed that both the UEMR and
ESD can effectively treat #10 mm rectal NETs with invasion depth confined to the mucosa
and submucosa. Then, UEMR is superior to ESD in operation time, hospitalization time,
operation cost, postoperative abdominal pain and abdominal distention. Their conclusions were
acceptable, but I would like to some suggestions to improve their manuscripts.
Major comments
1) Some pathological diagnosis were important to evaluate curability of endoscopic resections.
Authors should clarify which pathological criteria used in this study, e.g. WHO 2019 and add
appropriate reference about it in method section. Grade of NETs (1-3) and lymphovascular
invasions were very important risk factors about metastases, so please clarify data of them.
2) In discussion methods, comparison of UEMR and other EMR methods were insufficient.
Endoscopic submucosal resection with ligation device (ESMR-L) and endoscopic mucosal
resection with cap (EMR-C) were considered effective and safe methods. Authors should fully
discussed about difference of them and UEMR in discussion section.
Minor comments
1) In abstract (P2, L6), #10 mm seemed to be a mistake. Please correct it to #10 mm which
used in main text.
2) In abstract (P2, L10), the histological complete resection rate of ESD was 96.4% based on
main result. Please correct it.
3) In methods section (P4,L10-18), a paragraph of “General information should be transferred
to results section.
4) In methods section (P5, L 2 and L18), please clarify two experienced endoscopists performing
UEMR and ESD were same or not.
5) In methods section (P6, L10), was microscopic hemostasis correct? I think endoscopic
hemostasis was correct. Please check it.
6) About figure legends of Figure 2. Explanations of each figures were insufficient. Please
explain each figures with numbering them.
7) About table 2, operation cost were written using yuan. Using USD seemed to be easy to
understand for most of readers.
8) Yamashina T, et al. published a first case series about UEMR for rectal NETs in Endoscopy
international open (EIO)(2018; 6: E111-4). Please refer it in discussion section.
Title: Underwater endoscopic mucosal resection for rectal neuroendocrine tumors (with videos):
a single center retrospective study
Version: 2 Date: 22 Mar 2022
Reviewer's report:
Shi H, et al. investigated a single center retrospective comparative study of underwater
endoscopic mucosal resection (UEMR) and endoscopic submucosal dissection (ESD) for rectal
neuroendocrine tumors (NETs) #10 mm. Their results revealed that both the UEMR and
ESD can effectively treat #10 mm rectal NETs with invasion depth confined to the mucosa
and submucosa. Then, UEMR is superior to ESD in operation time, hospitalization time,
operation cost, postoperative abdominal pain and abdominal distention. Their conclusions were
acceptable, but I would like to some suggestions to improve their manuscripts.
Major comments
1) Some pathological diagnosis were important to evaluate curability of endoscopic resections.
Authors should clarify which pathological criteria used in this study, e.g. WHO 2019 and add
appropriate reference about it in method section. Grade of NETs (1-3) and lymphovascular
invasions were very important risk factors about metastases, so please clarify data of them.
2) In discussion methods, comparison of UEMR and other EMR methods were insufficient.
Endoscopic submucosal resection with ligation device (ESMR-L) and endoscopic mucosal
resection with cap (EMR-C) were considered effective and safe methods. Authors should fully
discussed about difference of them and UEMR in discussion section.
Minor comments
1) In abstract (P2, L6), #10 mm seemed to be a mistake. Please correct it to #10 mm which
used in main text.
2) In abstract (P2, L10), the histological complete resection rate of ESD was 96.4% based on
main result. Please correct it.
3) In methods section (P4,L10-18), a paragraph of “General information should be transferred
to results section.
4) In methods section (P5, L 2 and L18), please clarify two experienced endoscopists performing
UEMR and ESD were same or not.
5) In methods section (P6, L10), was microscopic hemostasis correct? I think endoscopic
hemostasis was correct. Please check it.
6) About figure legends of Figure 2. Explanations of each figures were insufficient. Please
explain each figures with numbering them.
7) About table 2, operation cost were written using yuan. Using USD seemed to be easy to
understand for most of readers.
8) Yamashina T, et al. published a first case series about UEMR for rectal NETs in Endoscopy
international open (EIO)(2018; 6: E111-4). Please refer it in discussion section.
Please review this paper.
user
Title: Underwater endoscopic mucosal resection for rectal neuroendocrine tumors (with videos):
a single center retrospective study
Version: 2 Date: 22 Mar 2022
Reviewer's report:
Shi H, et al. investigated a single center retrospective comparative study of underwater
endoscopic mucosal resection (UEMR) and endoscopic submucosal dissection (ESD) for rectal
neuroendocrine tumors (NETs) #10 mm. Their results revealed that both the UEMR and
ESD can effectively treat #10 mm rectal NETs with invasion depth confined to the mucosa
and submucosa. Then, UEMR is superior to ESD in operation time, hospitalization time,
operation cost, postoperative abdominal pain and abdominal distention. Their conclusions were
acceptable, but I would like to some suggestions to improve their manuscripts.
Major comments
1) Some pathological diagnosis were important to evaluate curability of endoscopic resections.
Authors should clarify which pathological criteria used in this study, e.g. WHO 2019 and add
appropriate reference about it in method section. Grade of NETs (1-3) and lymphovascular
invasions were very important risk factors about metastases, so please clarify data of them.
2) In discussion methods, comparison of UEMR and other EMR methods were insufficient.
Endoscopic submucosal resection with ligation device (ESMR-L) and endoscopic mucosal
resection with cap (EMR-C) were considered effective and safe methods. Authors should fully
discussed about difference of them and UEMR in discussion section.
Minor comments
1) In abstract (P2, L6), #10 mm seemed to be a mistake. Please correct it to #10 mm which
used in main text.
2) In abstract (P2, L10), the histological complete resection rate of ESD was 96.4% based on
main result. Please correct it.
3) In methods section (P4,L10-18), a paragraph of “General information should be transferred
to results section.
4) In methods section (P5, L 2 and L18), please clarify two experienced endoscopists performing
UEMR and ESD were same or not.
5) In methods section (P6, L10), was microscopic hemostasis correct? I think endoscopic
hemostasis was correct. Please check it.
6) About figure legends of Figure 2. Explanations of each figures were insufficient. Please
explain each figures with numbering them.
7) About table 2, operation cost were written using yuan. Using USD seemed to be easy to
understand for most of readers.
8) Yamashina T, et al. published a first case series about UEMR for rectal NETs in Endoscopy
international open (EIO)(2018; 6: E111-4). Please refer it in discussion section.
assistant