We would like to thank Dr Ichimasa and colleagues for their comments on our recent publication reporting the 3-year oncological outcomes of endoscopic intermuscular dissection (EID) for deep submucosal invasive rectal cancer. 1 2 We appreciate their engagement with our work and welcome the opportunity to address the points they raised.
Their primary concern is the potential impact of EID on completion total mesorectal excision (TME), particularly the risk of anastomotic leakage. While endoscopic submucosal dissection (ESD) has not been associated with an increased risk of postoperative complications, including anastomotic leakage, 3 the impact of EID remains to be investigated.
In our cohort, 53 of 177 patients (30%) underwent completion TME, comprising 38 low anterior resections and 15% abdominoperineal resections. The overall adverse event rate was 34% (18/53).
This rate is comparable to a recent propensity score-matched nationwide cohort, which reported adverse event rates of...
Gut (BMJ) published a clinical update in Research Highlights on 06 Mar 2026.
The item focuses on Response to: 'Endoscopic intermuscular dissection for rectal cancer: are we ready to skip surgery?
by Ichimasa et al.
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