{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:07:56Z","timestamp":1785308876723,"version":"3.55.0"},"reference-count":28,"publisher":"The Korean Society of Gastrointestinal Endoscopy","issue":"4","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-ce.org"],"crossmark-restriction":true},"short-container-title":["Clin Endosc"],"published-print":{"date-parts":[[2026,7,30]]},"abstract":"<jats:p>Background\/Aims: Subepithelial lesions (SELs) are frequently encountered in the upper and lower gastrointestinal (GI) tracts during routine endoscopy. As a significant proportion of SELs harbor malignant potential, a definitive diagnosis with tissue sampling should be sought in most patients. However, small SELs (&lt;20 mm) represent a clinical challenge because endoscopic ultrasound-guided tissue acquisition may not be as efficient under these circumstances. Furthermore, mucosal incision biopsies require equipment that is not universally available.Methods: We retrospectively investigated the diagnostic yield and safety of cold snare unroofing in an observational cohort.Results: A total of 71 SELs (41 in the upper GI tract and 30 in the lower GI tract) with a median size of 10 mm (range, 3\u201360 mm) were included. Unroofing resulted in a histologic diagnosis in 85% (n=60) of cases, with no further diagnostic procedures or surveillance required in 88.3% (n=53\/60). The final diagnoses consisted of 10 different etiologies, including three GI stromal tumors, one neuroendocrine tumor, and 44 lipomas. No significant complications, such as bleeding or perforation, were observed.Conclusions: Cold snare unroofing represents an efficient and easy method for characterizing small SELs in the upper and lower GI tracts, offering a valuable alternative to mucosal incision-assisted biopsy (MIAB) and endoscopic ultrasound with fine-needle biopsy.<\/jats:p>","DOI":"10.5946\/ce.2025.405","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:47:27Z","timestamp":1785307647000},"page":"633-641","update-policy":"https:\/\/doi.org\/10.5946\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Upfront unroofing of subepithelial lesions using cold snare in the upper and lower gastrointestinal tract: a retrospective study from Switzerland"],"prefix":"10.5946","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8507-0619","authenticated-orcid":true,"given":"Bernhard","family":"Morell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4099-4200","authenticated-orcid":true,"given":"Jasmina El","family":"Hadad-Burla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3541-8370","authenticated-orcid":true,"given":"Frans 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