{"id":"https://openalex.org/W7166350767","doi":"https://doi.org/10.1016/j.vgie.2026.06.009","title":"Underwater\u2013assisted hybrid endoscopic submucosal dissection to ensure an adequate vertical margin for colorectal cancer with deep submucosal invasion","display_name":"Underwater\u2013assisted hybrid endoscopic submucosal dissection to ensure an adequate vertical margin for colorectal cancer with deep submucosal invasion","publication_year":2026,"publication_date":"2026-06-01","ids":{"openalex":"https://openalex.org/W7166350767","doi":"https://doi.org/10.1016/j.vgie.2026.06.009"},"language":"en","primary_location":{"id":"doi:10.1016/j.vgie.2026.06.009","doi":"https://doi.org/10.1016/j.vgie.2026.06.009","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.vgie.2026.06.009","pdf_url":null,"source":{"id":"https://openalex.org/S2898416378","display_name":"VideoGIE","issn_l":"2468-4481","issn":["2468-4481"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1","poland-20"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"VideoGIE","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1016/j.vgie.2026.06.009","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5110957627","display_name":"Yudai Takehara","orcid":"https://orcid.org/0009-0000-0350-8553","observed_orcids":["https://orcid.org/0009-0000-0350-8553"]},"institutions":[{"id":"https://openalex.org/I4210164854","display_name":"Onomichi General Hospital","ror":"https://ror.org/05nr3de46","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210164854"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Yudai Takehara","raw_affiliation_strings":["Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan"],"raw_orcid":"https://orcid.org/0009-0000-0350-8553","affiliations":[{"raw_affiliation_string":"Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan","institution_ids":["https://openalex.org/I4210164854"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5053039062","display_name":"Fumiaki Tanino","orcid":"https://orcid.org/0009-0007-0331-1102","observed_orcids":["https://orcid.org/0009-0007-0331-1102"]},"institutions":[{"id":"https://openalex.org/I4210164854","display_name":"Onomichi General Hospital","ror":"https://ror.org/05nr3de46","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210164854"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Fumiaki Tanino","raw_affiliation_strings":["Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan","institution_ids":["https://openalex.org/I4210164854"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5090096734","display_name":"Masaki Wakai","orcid":"https://orcid.org/0000-0001-8648-7849","observed_orcids":["https://orcid.org/0000-0001-8648-7849"]},"institutions":[{"id":"https://openalex.org/I4210164854","display_name":"Onomichi General Hospital","ror":"https://ror.org/05nr3de46","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210164854"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Masaki Wakai","raw_affiliation_strings":["Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan","institution_ids":["https://openalex.org/I4210164854"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5085799813","display_name":"Seiji Onogawa","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210164854","display_name":"Onomichi General Hospital","ror":"https://ror.org/05nr3de46","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210164854"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Seiji Onogawa","raw_affiliation_strings":["Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan","institution_ids":["https://openalex.org/I4210164854"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5139473007","display_name":"Keiji Hanada","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210164854","display_name":"Onomichi General Hospital","ror":"https://ror.org/05nr3de46","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210164854"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Keiji Hanada","raw_affiliation_strings":["Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Gastroenterology, Onomichi General Hospital, Hiroshima, Japan","institution_ids":["https://openalex.org/I4210164854"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5110875913","display_name":"Shuji Yonehara","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210164854","display_name":"Onomichi General Hospital","ror":"https://ror.org/05nr3de46","country_code":"JP","type":"healthcare","lineage":["https://openalex.org/I4210164854"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Shuji Yonehara","raw_affiliation_strings":["Department of Pathology, Onomichi General Hospital, Hiroshima, Japan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pathology, Onomichi General Hospital, Hiroshima, Japan","institution_ids":["https://openalex.org/I4210164854"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5110957627"],"corresponding_institution_ids":["https://openalex.org/I4210164854"],"apc_list":{"value":1000,"currency":"USD","value_usd":1000},"apc_paid":{"value":1000,"currency":"USD","value_usd":1000},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"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/T10552","display_name":"Colorectal Cancer Screening and Detection","score":0.9574999809265137,"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/T10552","display_name":"Colorectal Cancer Screening and Detection","score":0.9574999809265137,"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/T10696","display_name":"Gastric Cancer Management and Outcomes","score":0.029600000008940697,"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/T10335","display_name":"Colorectal Cancer Surgical Treatments","score":0.0052999998442828655,"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"}}],"keywords":[{"id":"https://openalex.org/keywords/colorectal-cancer","display_name":"colorectal cancer","score":0.8309999704360962},{"id":"https://openalex.org/keywords/t1-colorectal-cancer","display_name":"T1 colorectal cancer","score":0.8159999847412109},{"id":"https://openalex.org/keywords/deep-submucosal-invasion","display_name":"deep submucosal invasion","score":0.9340000152587891},{"id":"https://openalex.org/keywords/vertical-margin","display_name":"vertical margin","score":0.9259999990463257},{"id":"https://openalex.org/keywords/endoscopic-resection","display_name":"endoscopic resection","score":0.8610000014305115},{"id":"https://openalex.org/keywords/cecal-lesions","display_name":"cecal lesions","score":0.7319999933242798},{"id":"https://openalex.org/keywords/submucosal-injection","display_name":"submucosal injection","score":0.8019999861717224},{"id":"https://openalex.org/keywords/buoyancy-effects","display_name":"buoyancy effects","score":0.8629999756813049},{"id":"https://openalex.org/keywords/lymph-node-metastasis-risk","display_name":"lymph node metastasis risk","score":0.6890000104904175}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9843000173568726},{"id":"https://openalex.org/C2777137803","wikidata":"https://www.wikidata.org/wiki/Q11394587","display_name":"Endoscopic submucosal dissection","level":2,"score":0.8719000220298767},{"id":"https://openalex.org/C526805850","wikidata":"https://www.wikidata.org/wiki/Q188874","display_name":"Colorectal cancer","level":3,"score":0.5874999761581421},{"id":"https://openalex.org/C774472","wikidata":"https://www.wikidata.org/wiki/Q6760393","display_name":"Margin (machine learning)","level":2,"score":0.5830000042915344},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.5209000110626221},{"id":"https://openalex.org/C2775862295","wikidata":"https://www.wikidata.org/wiki/Q2660911","display_name":"Dissection (medical)","level":2,"score":0.44940000772476196},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.4140999913215637},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.35910001397132874},{"id":"https://openalex.org/C2778866283","wikidata":"https://www.wikidata.org/wiki/Q3257565","display_name":"Endoscopic mucosal resection","level":3,"score":0.29829999804496765},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.2825999855995178},{"id":"https://openalex.org/C2778451229","wikidata":"https://www.wikidata.org/wiki/Q212809","display_name":"Endoscopy","level":2,"score":0.27970001101493835}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1016/j.vgie.2026.06.009","doi":"https://doi.org/10.1016/j.vgie.2026.06.009","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.vgie.2026.06.009","pdf_url":null,"source":{"id":"https://openalex.org/S2898416378","display_name":"VideoGIE","issn_l":"2468-4481","issn":["2468-4481"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1","poland-20"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"VideoGIE","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1016/j.vgie.2026.06.009","doi":"https://doi.org/10.1016/j.vgie.2026.06.009","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.vgie.2026.06.009","pdf_url":null,"source":{"id":"https://openalex.org/S2898416378","display_name":"VideoGIE","issn_l":"2468-4481","issn":["2468-4481"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1","poland-20"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"VideoGIE","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":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":7,"referenced_works":["https://openalex.org/W1941390526","https://openalex.org/W1979453436","https://openalex.org/W3152678470","https://openalex.org/W4205804637","https://openalex.org/W4399583647","https://openalex.org/W4404556487","https://openalex.org/W4412619267"],"related_works":["https://openalex.org/W4403738392","https://openalex.org/W4415639283","https://openalex.org/W2768551201","https://openalex.org/W4415639159","https://openalex.org/W3141505075","https://openalex.org/W7203694634","https://openalex.org/W4404556487","https://openalex.org/W4412619267","https://openalex.org/W3142474148","https://openalex.org/W2551610422"],"abstract_inverted_index":{"Background":[0],"and":[1,38,66,79,121,124],"Aims":[2],"Ensuring":[3],"an":[4,40,143],"adequate":[5,41,144],"vertical":[6,122],"margin":[7],"(VM)":[8],"is":[9],"critical":[10],"in":[11],"endoscopic":[12,28],"resection":[13],"(ER)":[14],"for":[15,49,141,146],"T1":[16,60],"colorectal":[17],"cancer":[18],"(CRC).":[19],"We":[20,44],"aimed":[21],"to":[22,33,87],"demonstrate":[23],"a":[24,50,112,125],"novel":[25],"underwater-assisted":[26,46],"hybrid":[27,47,133],"submucosal":[29,36,68,77,90,113],"dissection":[30],"(ESD)":[31],"strategy":[32,140],"optimize":[34],"deep":[35,59,89],"capture":[37,91],"ensure":[39],"VM.":[42],"Methods":[43],"performed":[45,86],"ESD":[48,134],"20-mm":[51],"Paris":[52],"type":[53],"0-IIa+IIc":[54],"cecal":[55],"lesion":[56,98],"suspected":[57],"of":[58,116,128,171],"CRC.":[61],"After":[62],"circumferential":[63,67],"mucosal":[64],"incision":[65],"dissection,":[69],"the":[70,93,168],"lumen":[71],"was":[72,99],"filled":[73],"with":[74,111],"saline.":[75],"Additional":[76],"injection":[78],"snaring":[80],"under":[81],"underwater":[82],"condition":[83],"were":[84],"then":[85],"facilitate":[88],"using":[92],"buoyancy":[94],"effect.":[95],"Results":[96],"The":[97],"successfully":[100],"resected":[101],"en":[102],"bloc":[103],"without":[104],"adverse":[105],"events.":[106],"Histopathology":[107],"revealed":[108],"pT1b":[109,155],"adenocarcinoma":[110],"invasion":[114],"depth":[115],"2300":[117],"\u03bcm,":[118],"negative":[119],"horizontal":[120],"margins,":[123],"VM":[126,145],"distance":[127],"1020":[129],"\u03bcm.":[130],"Conclusions":[131],"Underwater-assisted":[132],"may":[135],"represent":[136],"one":[137],"possible":[138],"ER":[139],"ensuring":[142],"T1b":[147],"CRC":[148],"\u226430":[149],"mm.":[150],"When":[151],"pathological":[152],"evaluation":[153],"reveals":[154],"CRC,":[156],"additional":[157],"surgical":[158],"management":[159],"should":[160],"generally":[161],"be":[162],"considered":[163],"through":[164],"multidisciplinary":[165],"assessment,":[166],"given":[167],"potential":[169],"risk":[170],"lymph":[172],"node":[173],"metastasis.":[174]},"counts_by_year":[],"updated_date":"2026-11-13T13:42:25.865203","created_date":"2026-06-28T00:00:00"}