{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:52:22Z","timestamp":1791417142977,"version":"4.3.3"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Endoscopic resection of Barrett\u2019s esophageal neoplasia is commonly performed using either endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR). While submucosal dissection enables en bloc resection, institutional approaches vary. We compared clinical, histopathologic, and oncologic outcomes between a primary submucosal dissection strategy and a mucosal resection-based strategy with selective use of submucosal dissection.<\/jats:p>\n                  <jats:p>Methods This retrospective cohort study included all patients with Barrett\u2019s esophageal neoplasia treated at two European tertiary referral centers. At Karolinska University Hospital, the primary submucosal dissection strategy was adopted, whereas at Erasmus Medical Center the mucosal resection-based strategy was employed. Patients with prior endoscopic therapy or hematologic disorders were excluded. Primary outcomes were local recurrence, synchronous and metachronous lesions prior to ablation, and cancer- or treatment-related mortality. Secondary outcomes included resection quality, adverse events, and the need for repeated resections. Time-to-event analyses were performed using Kaplan\u2013Meier and Cox regression models.<\/jats:p>\n                  <jats:p>Results A total of 332 patients were included (132 in the primary submucosal dissection group and 200 in the mucosal resection\u2013based group). En bloc resection was more frequent with the primary submucosal dissection strategy (98.5% vs 40.0%, p &lt; 0.001). Compared with the EMR-based strategy, the pESD strategy was associated with significantly lower local recurrence (3.0% vs 10.0%, p = 0.02) and fewer resection sessions per patient, whereas rates of synchronous and metachronous lesions were similar between groups. Adverse events and cancer- or treatment-related mortality did not differ between strategies.<\/jats:p>\n                  <jats:p>Conclusions Both strategies are safe. However, the primary submucosal dissection strategy is associated with lower local recurrence and fewer resection sessions.<\/jats:p>","DOI":"10.1055\/a-2961-1399","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:42:11Z","timestamp":1791416531000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Comparison of Primary Endoscopic Submucosal Dissection versus Primary Endoscopic Mucosal Resection for Barrett\u2019s Esophageal Neoplasia Treatment"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0115-2511","authenticated-orcid":false,"given":"Masami","family":"Omae","sequence":"first","affiliation":[{"name":"Karolinska University Hospital, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Upper Abdominal Diseases"]},{"name":"Karolinska Institute, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Medicine Huddinge"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0568-7188","authenticated-orcid":false,"given":"Annemijn D.I.","family":"Maan","sequence":"first","affiliation":[{"name":"Erasmus MC Cancer Institute, University Medical Center, the Netherlands","place":["Rotterdam"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Maltzman","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Upper Abdominal Diseases"]},{"name":"Karolinska Institute, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miroslav","family":"Vujasinovic","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Upper Abdominal Diseases"]},{"name":"Karolinska Institute, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Medicine Huddinge"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Upper Abdominal Diseases"]},{"name":"Karolinska Institute, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Klevebro","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Upper Abdominal Diseases"]},{"name":"Karolinska Institute, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun D.","family":"Koch","sequence":"additional","affiliation":[{"name":"Erasmus MC Cancer Institute, University Medical Center, the Netherlands","place":["Rotterdam"],"department":["Department of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0631-1945","authenticated-orcid":false,"given":"Francisco","family":"Baldaque-Silva","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Upper Abdominal Diseases"]},{"name":"Karolinska Institute, Stockholm County, Sweden","place":["Stockholm"],"department":["Department of Medicine Huddinge"]},{"name":"Hospital Pedro Hispano, Portugal","place":["Matosinhos"],"department":["Gastroenterology Department, Center for Advanced Endoscopy Carlos Moreira da Silva"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1136\/gutjnl-2015-309298","article-title":"Multimodality endoscopic eradication for neoplastic Barrett oesophagus: results 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