<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452024000100041</article-id>
<article-id pub-id-type="doi">10.1159/000528107</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Endoscopic Submucosal Dissection Is Safe and Effective for Lesions Located at the Anorectal Junction: Analysis from Two Referral European Centers]]></article-title>
<article-title xml:lang="pt"><![CDATA[A dissecção endoscópica da submucosa é um tratamento seguro e eficaz para lesões da junção ano-rectal: a experiência de dois centros europeus de referência]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Mariana Figueiredo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marques]]></surname>
<given-names><![CDATA[Margarida]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morais]]></surname>
<given-names><![CDATA[Rui]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lemmers]]></surname>
<given-names><![CDATA[Arnaud]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Macedo]]></surname>
<given-names><![CDATA[Guilherme]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santos-Antunes]]></surname>
<given-names><![CDATA[João]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar S. João Faculty of Medicine Gastroenterology Department]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Université Libre de Bruxelles (ULB) Hepatopancreatology and Digestive Oncology, CUB Erasme Hospital Department of Gastroenterology]]></institution>
<addr-line><![CDATA[Brussels ]]></addr-line>
<country>Belgium</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidade do Porto Ipatimup/i3S (Instituto de Investigação e Inovação em Saúde ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>28</day>
<month>02</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>28</day>
<month>02</month>
<year>2024</year>
</pub-date>
<volume>31</volume>
<numero>1</numero>
<fpage>41</fpage>
<lpage>47</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452024000100041&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452024000100041&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452024000100041&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Endoscopic submucosal dissection (ESD) is a well-established resection technique for colorectal superficial tumors, but its role in the treatment of anorectal junction (ARJ) lesions still remains to be determined. With this study, we aimed to evaluate the feasibility, safety, and efficacy of ESD for the resection of ARJ lesions, in comparison to more proximal rectal lesions.  Methods:  We performed a retrospective analysis of prospectively collected data concerning all consecutive rectal ESD procedures performed in two European centers, from 2015 to 2021.  Results:  A total of two hundred and fifty-two rectal lesions were included. Sixty (24%) were ARJ lesions, and the remaining 192 (76%) were located proximally. Technical success was achieved in 248 procedures (98%), and its rate was similar in both locations (p = 0.246). Most of the lesions presented high-grade dysplasia/Tis adenocarcinoma (54%); 36 (15%) had submucosal adenocarcinoma, including 20 superficial (sm1) and 16 deeply invasive (&gt;SM1) T1 cancers. We found no differences between ARJ and rectal lesions in regard to en bloc resection rate (100% vs. 96%, p = 0.204), R0 resection rate (76% vs. 75%, p = 0.531), curative resection rate (70% vs. 70%, p = 0.920), procedures&#8217; median duration (120 min vs. 90 min, p = 0.072), ESD velocity (14 vs. 12 mm2/min, p = 0.415), histopathology result (p = 0.053), and the need for surgery due to a non-curative ESD (5% vs. 3%, p = 0.739). Also, there was no statistically significant difference that concerns delayed bleeding (7% vs. 8%, p = 0.709), perforation (0% vs. 5%, p = 0.075), or the need for readmission (2% vs. 2%, p = 0.939). Nevertheless, anorectal stenosis (5% vs. 0%, p = 0.003) and anorectal pain (9% vs. 1%, p = 0.002) were significantly more frequent in ARJ lesions.  Conclusion:  ESD is a safe and efficient resection technique for the treatment of rectal lesions located in the ARJ.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A dissecção endoscópica da submucosa (ESD) é uma técnica endoscópica com demonstrada eficácia nas lesões neoplásicas superficiais colorectais. No entanto, a evidência da sua eficácia nas lesões localizadas na junção ano-rectal é escassa. O nosso objectivo foi avaliar a segurança e eficácia da ESD nas lesões da junção ano-rectal (menos de 2 cm da linha pectínea), em comparação com as lesões mais proximais do recto.  Métodos:  Análise retrospectiva de registos colhidos prospectivamente de dois centros europeus de referência, entre 2015 e 2021.  Resultados:  Foram incluídas 252 lesões. Sessenta (24%) localizavam-se na junção ano-rectal, e as restantes 192 noutro local do recto. O sucesso técnico foi de 98% (n = 248) e foi semelhante nas 2 localizações (p = 0.246). A maioria das lesões eram displasias de alto grau/Tis (54%); 36 (15%) tinham adenocarcinoma submucoso, tendo 20 invasão submucosa superficial (sm1) e 16 invasão profunda (&gt;SM1). Não foram encontradas diferenças entre as duas localizações relativamente às taxas de ressecção em bloco (100% vs. 96%, p = 0.204), R0 (76% vs. 75%, p = 0.531), ou curativa (70% vs. 70%, p = 0.920), duração da ESD (mediana 120 min vs. 90 min, p = 0.072), velocidade da ESD (14 vs. 12 mm2/min, p = 0.415) ou resultado histológico (p = 0.053), assim como na necessidade de cirurgia por ESD não curativa (5% vs. 3%, p = 0.739). Além disso, as taxas de hemorragia tardia (7% vs. 8%, p = 0.709), perfuração (0% vs. 5%, p = 0.075) e necessidade de internamento por complicações (2% vs. 2%, p = 0.939) não revelaram diferenças estatisticamente significativas. A estenose ano-rectal (5% vs. 0%, p = 0.003) e a dor ano-rectal (9% vs. 1%, p = 0.002) foram mais frequentes nas lesões da junção ano-rectal.  Conclusão:  A ESD é uma técnica segura e eficaz no tratamento das lesões do recto localizadas na junção ano-rectal.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Endoscopic submucosal dissection]]></kwd>
<kwd lng="en"><![CDATA[Anorectal lesions]]></kwd>
<kwd lng="en"><![CDATA[Rectal lesions]]></kwd>
<kwd lng="pt"><![CDATA[Dissecção endoscópica da submucosa]]></kwd>
<kwd lng="pt"><![CDATA[Lesões ano-rectais]]></kwd>
<kwd lng="pt"><![CDATA[Lesões rectais]]></kwd>
</kwd-group>
</article-meta>
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<person-group person-group-type="author">
<name>
<surname><![CDATA[Sanchez-Yague]]></surname>
<given-names><![CDATA[A]]></given-names>
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<name>
<surname><![CDATA[Yamaguchi]]></surname>
<given-names><![CDATA[Y]]></given-names>
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<name>
<surname><![CDATA[Takao]]></surname>
<given-names><![CDATA[T]]></given-names>
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<name>
<surname><![CDATA[Tanaka]]></surname>
<given-names><![CDATA[M]]></given-names>
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<surname><![CDATA[Kakushima]]></surname>
<given-names><![CDATA[N]]></given-names>
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<article-title xml:lang=""><![CDATA[Endoscopic submucosal dissection of a lower rectal polyp proximal to the dentate line by using local lidocaine injection]]></article-title>
<source><![CDATA[Gastrointest Endosc]]></source>
<year>2011</year>
<volume>73</volume>
<numero>2</numero>
<issue>2</issue>
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