{"id":"https://openalex.org/W7136281980","doi":"https://doi.org/10.5946/ce.2025.330","title":"Underwater endoscopic submucosal dissection in the gastrointestinal tract: technical review and dual-approach endoscopic submucosal dissection","display_name":"Underwater endoscopic submucosal dissection in the gastrointestinal tract: technical review and dual-approach endoscopic submucosal dissection","publication_year":2026,"publication_date":"2026-03-16","ids":{"openalex":"https://openalex.org/W7136281980","doi":"https://doi.org/10.5946/ce.2025.330","pmid":"https://pubmed.ncbi.nlm.nih.gov/41956723"},"language":"en","primary_location":{"id":"doi:10.5946/ce.2025.330","doi":"https://doi.org/10.5946/ce.2025.330","is_oa":true,"landing_page_url":"https://doi.org/10.5946/ce.2025.330","pdf_url":null,"source":{"id":"https://openalex.org/S2755109226","display_name":"Clinical Endoscopy","issn_l":"2234-2400","issn":["2234-2400","2234-2443"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","doyens","kci-registered","ki-jl-1","norway-1","oarl","poland-70","russia-white-list-3"],"host_organization":"https://openalex.org/P4324113237","host_organization_name":"Korean Society of Gastrointestinal Endoscopy","host_organization_lineage":["https://openalex.org/P4324113237"],"host_organization_lineage_names":["Korean Society of Gastrointestinal Endoscopy"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Endoscopy","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.5946/ce.2025.330","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5039809651","display_name":"Mitsuru Nagata","orcid":"https://orcid.org/0000-0002-5697-5953","observed_orcids":["https://orcid.org/0000-0002-5697-5953"]},"institutions":[{"id":"https://openalex.org/I4405254078","display_name":"Shonan Fujisawa Tokusyukai Hospital","ror":"https://ror.org/01crjdg76","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4405254078"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Mitsuru Nagata","raw_affiliation_strings":["Department of Endoscopy, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Endoscopy, Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan","institution_ids":["https://openalex.org/I4405254078"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5039809651"],"corresponding_institution_ids":["https://openalex.org/I4405254078"],"apc_list":{"value":242,"currency":"USD","value_usd":242},"apc_paid":{"value":242,"currency":"USD","value_usd":242},"fwci":0.7977,"has_fulltext":true,"cited_by_count":1,"citation_normalized_percentile":{"value":0.60910982,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":91,"max":95},"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10696","display_name":"Gastric Cancer Management and Outcomes","score":0.9110999703407288,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10696","display_name":"Gastric Cancer Management and Outcomes","score":0.9110999703407288,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10552","display_name":"Colorectal Cancer Screening and Detection","score":0.06759999692440033,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11378","display_name":"Gastrointestinal Bleeding Diagnosis and Treatment","score":0.008799999952316284,"subfield":{"id":"https://openalex.org/subfields/2715","display_name":"Gastroenterology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/endoscopic-submucosal-dissection","display_name":"endoscopic submucosal dissection","score":0.9279999732971191},{"id":"https://openalex.org/keywords/gastrointestinal-cancer","display_name":"gastrointestinal cancer","score":0.8420000076293945},{"id":"https://openalex.org/keywords/submucous-fibrosis","display_name":"submucosal fibrosis","score":0.9959999918937683},{"id":"https://openalex.org/keywords/heat-sink-effect","display_name":"heat sink effect","score":0.8659999966621399}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9707000255584717},{"id":"https://openalex.org/C2777137803","wikidata":"https://www.wikidata.org/wiki/Q11394587","display_name":"Endoscopic submucosal dissection","level":2,"score":0.9431999921798706},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.4966000020503998},{"id":"https://openalex.org/C2775862295","wikidata":"https://www.wikidata.org/wiki/Q2660911","display_name":"Dissection (medical)","level":2,"score":0.47279998660087585},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.35269999504089355},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.33489999175071716},{"id":"https://openalex.org/C2778451229","wikidata":"https://www.wikidata.org/wiki/Q212809","display_name":"Endoscopy","level":2,"score":0.3312000036239624},{"id":"https://openalex.org/C98083399","wikidata":"https://www.wikidata.org/wiki/Q3246517","display_name":"Underwater","level":2,"score":0.3109000027179718},{"id":"https://openalex.org/C2778866283","wikidata":"https://www.wikidata.org/wiki/Q3257565","display_name":"Endoscopic mucosal resection","level":3,"score":0.2976999878883362},{"id":"https://openalex.org/C3020475014","wikidata":"https://www.wikidata.org/wiki/Q212809","display_name":"Endoscopic treatment","level":3,"score":0.21619999408721924}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.5946/ce.2025.330","doi":"https://doi.org/10.5946/ce.2025.330","is_oa":true,"landing_page_url":"https://doi.org/10.5946/ce.2025.330","pdf_url":null,"source":{"id":"https://openalex.org/S2755109226","display_name":"Clinical Endoscopy","issn_l":"2234-2400","issn":["2234-2400","2234-2443"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","doyens","kci-registered","ki-jl-1","norway-1","oarl","poland-70","russia-white-list-3"],"host_organization":"https://openalex.org/P4324113237","host_organization_name":"Korean Society of Gastrointestinal Endoscopy","host_organization_lineage":["https://openalex.org/P4324113237"],"host_organization_lineage_names":["Korean Society of Gastrointestinal Endoscopy"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Endoscopy","raw_type":"journal-article"},{"id":"pmid:41956723","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41956723","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical endoscopy","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.5946/ce.2025.330","doi":"https://doi.org/10.5946/ce.2025.330","is_oa":true,"landing_page_url":"https://doi.org/10.5946/ce.2025.330","pdf_url":null,"source":{"id":"https://openalex.org/S2755109226","display_name":"Clinical Endoscopy","issn_l":"2234-2400","issn":["2234-2400","2234-2443"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","doyens","kci-registered","ki-jl-1","norway-1","oarl","poland-70","russia-white-list-3"],"host_organization":"https://openalex.org/P4324113237","host_organization_name":"Korean Society of Gastrointestinal Endoscopy","host_organization_lineage":["https://openalex.org/P4324113237"],"host_organization_lineage_names":["Korean Society of Gastrointestinal Endoscopy"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Endoscopy","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9391000270843506,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7133352013","https://openalex.org/W4417457348","https://openalex.org/W7160894803","https://openalex.org/W7203790017","https://openalex.org/W4414001010","https://openalex.org/W4412938163","https://openalex.org/W4417458199","https://openalex.org/W2901849817","https://openalex.org/W4412203803","https://openalex.org/W4403526222"],"abstract_inverted_index":{"Endoscopic":[0],"submucosal":[1,35,60],"dissection":[2,61],"(ESD)":[3],"has":[4,154],"become":[5],"an":[6],"established":[7],"technique":[8],"for":[9,185],"en":[10],"bloc":[11],"resection":[12],"of":[13,77,197],"superficial":[14],"gastrointestinal":[15],"neoplasms.":[16],"However,":[17,102],"conventional":[18],"ESD":[19,38,153,184],"(CESD)":[20],"under":[21],"gas":[22],"insufflation":[23],"remains":[24],"technically":[25],"demanding,":[26],"particularly":[27],"in":[28,32,149,161],"gravity-side":[29],"lesions":[30],"or":[31,112],"cases":[33],"with":[34,95,167],"fibrosis.":[36],"Underwater":[37],"(UESD)":[39],"was":[40],"developed":[41],"to":[42,85,141],"overcome":[43],"these":[44],"challenges.":[45],"Complete":[46],"submergence":[47],"mitigates":[48],"gravity-related":[49],"difficulties,":[50],"enhances":[51],"visualization":[52],"through":[53],"the":[54,75,86,136],"natural":[55],"zoom":[56],"effect,":[57],"and":[58,64,98,117,133,174],"facilitates":[59],"via":[62],"buoyancy":[63],"water":[65],"pressure.":[66],"Retrospective":[67],"data":[68],"further":[69,122],"suggest":[70],"that":[71],"UESD":[72,90,125,132,160,181],"may":[73],"reduce":[74],"risk":[76],"post-ESD":[78],"coagulation":[79],"syndrome,":[80],"which":[81],"is":[82],"likely":[83],"attributable":[84],"heat":[87],"sink":[88],"effect.":[89],"can":[91],"also":[92],"be":[93],"integrated":[94],"device-assisted":[96],"traction":[97],"pocket":[99],"creation":[100],"methods.":[101],"limitations,":[103],"such":[104],"as":[105,142],"visual":[106],"field":[107],"impairment":[108],"caused":[109],"by":[110,129],"bleeding":[111],"bubble":[113],"formation,":[114],"remain":[115],"concerns,":[116],"their":[118],"optimal":[119],"management":[120],"requires":[121,194],"investigation.":[123],"Nevertheless,":[124],"allows":[126],"procedural":[127,192],"flexibility":[128],"switching":[130],"between":[131],"CESD":[134],"within":[135],"same":[137],"procedure,":[138],"herein":[139],"referred":[140],"dual-approach":[143,152,183],"ESD.":[144],"Despite":[145],"its":[146],"routine":[147],"use":[148],"clinical":[150,163,172],"practice,":[151],"not":[155],"been":[156],"clearly":[157,179],"distinguished":[158],"from":[159,182],"most":[162],"studies,":[164],"complicating":[165],"comparisons":[166],"CESD.":[168],"To":[169],"advance":[170],"both":[171],"practice":[173],"research,":[175],"future":[176],"investigations":[177],"should":[178],"differentiate":[180],"a":[186],"more":[187],"accurate":[188],"evaluation.":[189],"Furthermore,":[190],"appropriate":[191],"selection":[193],"careful":[195],"consideration":[196],"multiple":[198],"factors.":[199]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-03-17T00:00:00"}
