{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:16:03Z","timestamp":1786115763213,"version":"build-2736575974"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>\n                    Colorectal adenomatous polyps are well-established as the principal precancerous lesions underlying the adenoma-carcinoma sequence in colorectal carcinogenesis. The World Endoscopy Organization (WEO) consensus guidelines strongly advocate\n                    <jats:italic>en bloc<\/jats:italic>\n                    resection over piecemeal resection for laterally spreading lesions measuring &amp;gt;20\u2005mm in diameter, given their elevated risk of superficial submucosal invasion. Nevertheless, achieving complete\n                    <jats:italic>en bloc<\/jats:italic>\n                    resection via endoscopic submucosal dissection (ESD) for circumferential lesions situated immediately adjacent to the anal verge and exceeding 10\u2005cm in maximum dimension represents a formidable technical challenge. Herein, we report the successful\n                    <jats:italic>en bloc<\/jats:italic>\n                    ESD resection of a giant circumferential mixed-nodular laterally spreading lesion extending from the anal verge to 8\u2005cm proximally, with postoperative histopathology confirming moderately differentiated adenocarcinoma (Figure 5). The patient presented with concomitant schistosomal colopathy, which further compounded the procedural complexity of ESD. Notwithstanding these challenges, meticulous perioperative assessment, refined surgical technique, and comprehensive postoperative management collectively demonstrate that ESD remains a safe and effective therapeutic modality for appropriately selected patients.\n                  <\/jats:p>","DOI":"10.3389\/fsurg.2026.1888367","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:32:02Z","timestamp":1785994322000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic submucosal dissection for a giant circumferential early rectal cancer with massive schistosoma egg deposition: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuhang","family":"Cui","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Yijishan Hospital, Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linzhen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Yijishan Hospital, Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Yijishan Hospital, Wannan Medical College","place":["Wuhu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1056\/NEJMoa1100370","article-title":"Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths","volume":"366","author":"Zauber","year":"2012","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"56S","DOI":"10.1177\/00333549221143204","article-title":"Elevated adenomatous polyp detection rate among Alaska Native and American Indian people in Interior Alaska, 2018\u22122022","volume":"138","author":"Redwood","year":"2023","journal-title":"Public Health Rep"},{"key":"B3","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/s13000-024-01535-9","article-title":"Pseudoinvasion and squamous metaplasia\/morules in colorectal adenomatous polyp: a case report and literature review","volume":"19","author":"Shi","year":"2024","journal-title":"Diagn Pathol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1111\/den.14826","article-title":"International consensus on the management of large (\u226520mm) colorectal laterally spreading tumors: World Endoscopy Organization Delphi study","volume":"36","author":"Djinbachian","year":"2024","journal-title":"Dig Endosc"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1016\/j.cgh.2020.07.024","article-title":"Risk of covert submucosal cancer in patients with granular mixed laterally spreading tumors","volume":"19","author":"D\u2019Amico","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1111\/den.14223","article-title":"Outcomes of endoscopic submucosal dissection for colorectal neoplasms: prospective, multicenter, cohort trial","volume":"34","author":"Kobayashi","year":"2022","journal-title":"Dig Endosc"},{"key":"B7","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1097\/MCG.0000000000001844","article-title":"Curative effect analysis of endoscopic submucosal dissection in giant laterally spreading rectal tumors","volume":"58","author":"Nie","year":"2024","journal-title":"J Clin Gastroenterol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1055\/s-0043-114410","article-title":"Endoscopic submucosal dissection of colitis-related dysplasia","volume":"49","author":"Suzuki","year":"2017","journal-title":"Endoscopy"},{"key":"B9","doi-asserted-by":"publisher","first-page":"501","DOI":"10.4269\/ajtmh.18-0807","article-title":"Schistosoma japonicum-associated colorectal cancer: a review","volume":"100","author":"Hamid","year":"2019","journal-title":"Am J Trop Med Hyg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1186\/s12957-020-01925-5","article-title":"Comparison of non-schistosomal colorectal cancer and schistosomal colorectal cancer","volume":"18","author":"Wang","year":"2020","journal-title":"World J Surg Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1016\/j.gendis.2022.05.026","article-title":"Genomic analysis of schistosomiasis-associated colorectal cancer reveals a unique mutational landscape and therapeutic implications","volume":"10","author":"Yu","year":"2022","journal-title":"Genes Dis"},{"key":"B12","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1111\/den.13229","article-title":"Colonoscopy quality requisites for selecting surveillance intervals: a world endoscopy organization Delphi recommendation","volume":"30","author":"Jover","year":"2018","journal-title":"Dig Endosc"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1888367\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:32:03Z","timestamp":1785994323000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1888367\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":12,"alternative-id":["10.3389\/fsurg.2026.1888367"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1888367","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"article-number":"1888367"}}