{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:02:26Z","timestamp":1790157746893,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2027,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Adequate traction is essential for safe and efficient colorectal endoscopic submucosal dissection (ESD), but gravitational traction is often insufficient in certain situations. Several traction techniques are reportedly effective. We use the rubber\u2010clip method (RCM), which is a simple and inexpensive technique that combines a standard clip with a rubber band to allow directional traction adjustment. This study was performed to evaluate the clinical outcomes of RCM\u2010assisted colorectal ESD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 551 colorectal ESD procedures performed between January 2014 and October 2025, 452 patients were eligible for inclusion.\u00a0Propensity score matching using seven covariates yielded 56 RCM and 56 non\u2010RCM cases. The primary endpoint was procedure time, and the secondary endpoints were perforation, bleeding, en bloc resection, and pathological complete resection.\u00a0Additionally, all procedures were classified as long\u2010duration (\u2265120\u00a0min) or short\u2010duration (&lt;120\u00a0min) to identify independent risk factors for prolonged procedures, including intraoperative variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, the RCM group showed a significantly shorter procedure time than the non\u2010RCM group (66.8\u00a0vs. 90.7\u00a0min, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.024) and a lower perforation rate (0.0 % vs. 10.7%, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.027). In the multivariate analysis, absence of traction, non\u2010expert endoscopist, moderate\u2010to\u2010severe fibrosis, large lesion size, and poor maneuverability were independent risk factors for prolonged procedures, with absence of traction showing the strongest association.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The RCM shortened procedure time and reduced perforation risk. Given its low cost, simplicity, and ability to adjust traction direction, the RCM may represent an effective traction method for colorectal ESD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      <jats:bold>Trial Registration<\/jats:bold>\n                      : N\/A.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/deo2.70415","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:12:58Z","timestamp":1790154778000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes of Rubber\u2010clip\u2010assisted Versus Conventional Colorectal Endoscopic Submucosal Dissection: A Retrospective Study"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2395-0503","authenticated-orcid":false,"given":"Kohei","family":"Uyama","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6312-8541","authenticated-orcid":false,"given":"Hiroyoshi","family":"Iwagami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical Center  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Akamatsu","sequence":"additional","affiliation":[{"name":"Akamatsu Gastroenterology, Hepatology and Endoscopy Clinic  Wakayama 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