{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T12:24:14Z","timestamp":1792239854242,"version":"4.4.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Endoscopic and radiological staging of early rectal cancer (ERC) remains suboptimal, contributing to inaccurate treatment allocation and the risk of under- and overtreatment. This study aimed to evaluate the feasibility and safety of the Pocket-detection method with Real-time Intraprocedural Muscle-retracting sign Evaluation (PRIME) resection algorithm for ERC.<\/jats:p>\n                  <jats:p>We retrospectively analyzed a prospective registry of rectal lesions managed according to the PRIME algorithm between August 2023 and October 2025. The muscle-retracting sign (MRS) status guided adaptive dissection plane selection: endoscopic submucosal dissection (ESD) if MRS negative; endoscopic intermuscular dissection (EID) or full-thickness resection (knife-assisted [kFTR] or device-assisted [FTRD]) for MRS-positive lesions. Primary outcomes were technical success and the rate of R0 endoscopic resection. The secondary outcomes were the technical success of deep-margin optical diagnosis and adverse events.<\/jats:p>\n                  <jats:p>47 lesions were included. MRS prevalence was 34.0% (16\/47). Technical success of endoscopic resection was 97.9% (46\/47; 95%CI 88.7%\u201399.9%). ESD was performed in 31 lesions, EID in nine, kFTR in five, and FTRD in one. R0 resection was achieved in 89.1% (41\/46; 95%CI 76.4%\u201396.4%) and R0 vertical margin in 95.7% (44\/46; 95%CI 85.2%\u201399.5%). Technical success of deep-margin optical diagnosis was 100% (47\/47; 95%CI 92.5%\u2013100%). Nonsevere (AGREE classification grade I\u2013IIIa) adverse events occurred in 10.6% of patients (5\/47; 95%CI 3.5%\u201323.1%).<\/jats:p>\n                  <jats:p>The MRS-guided adaptive endoscopic resection algorithm (PRIME) was feasible and safe for ERC achieving high R0 rates. These findings support its validation in larger studies with longer follow-up.<\/jats:p>","DOI":"10.1055\/a-2898-7122","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T22:53:25Z","timestamp":1782946405000},"source":"Crossref","is-referenced-by-count":1,"title":["Feasibility and safety of an adaptive endoscopic resection algorithm guided by the muscle-retracting sign for early rectal cancer"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0285-9949","authenticated-orcid":false,"given":"Andrea","family":"Sorge","sequence":"first","affiliation":[{"name":"University Hospital Ghent, Flanders, Belgium","place":["Ghent"],"department":["Department of Gastroenterology and Hepatology"]},{"name":"University of Padua, Italy","place":["Padua"],"department":["Department of Surgery, Oncology and Gastroenterology"]},{"name":"Azienda Ospedale Universit\u00e0 Padova, Italy","place":["Padua"],"department":["Gastroenterology Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Eva","family":"Argenziano","sequence":"first","affiliation":[{"name":"University Hospital Ghent, Flanders, Belgium","place":["Ghent"],"department":["Department of Gastroenterology and Hepatology"]},{"name":"Ghent University, Belgium","place":["Ghent"],"department":["Faculty of Medicine and Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3529-5040","authenticated-orcid":false,"given":"Pieter Jan","family":"Poortmans","sequence":"additional","affiliation":[{"name":"University Hospital Ghent, Flanders, Belgium","place":["Ghent"],"department":["Department of Gastroenterology and Hepatology"]},{"name":"Ghent University, Belgium","place":["Ghent"],"department":["Faculty of Medicine and Health Sciences"]},{"name":"UZ Brussel, Belgium","place":["Brussels"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Montori","sequence":"additional","affiliation":[{"name":"University Hospital Ghent, Flanders, Belgium","place":["Ghent"],"department":["Department of Gastroenterology and Hepatology"]},{"name":"Universit\u00e0 Politecnica delle Marche, Italy","place":["Ancona"],"department":["Clinic of Gastroenterology, Hepatology and Emergency Digestive Endoscopy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamas","family":"Tornai","sequence":"additional","affiliation":[{"name":"University Hospital Ghent, Flanders, Belgium","place":["Ghent"],"department":["Department of Gastroenterology and Hepatology"]},{"name":"Semmelweis University, Hungary","place":["Budapest"],"department":["Institute of Pancreatic Diseases"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Hoorens","sequence":"additional","affiliation":[{"name":"University Hospital Ghent, Belgium","place":["Ghent"],"department":["Department of Pathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn K.","family":"Debels","sequence":"additional","affiliation":[{"name":"University Hospital Ghent, Flanders, Belgium","place":["Ghent"],"department":["Department of Gastroenterology and Hepatology"]},{"name":"Ghent University, Belgium","place":["Ghent"],"department":["Faculty of Medicine and Health Sciences"]},{"name":"UZ Brussel, Belgium","place":["Brussels"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo Vincenzo","family":"Savarino","sequence":"additional","affiliation":[{"name":"University of Padua, Italy","place":["Padua"],"department":["Department of Surgery, Oncology and Gastroenterology"]},{"name":"Azienda Ospedale Universit\u00e0 Padova, Italy","place":["Padua"],"department":["Gastroenterology 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