Review for 10.1186/s12876-022-02202-3 (2022)

Reviewer’s report
Title: 
Prophylactic clip closure for mucosal defects is associated with reduced
adverse events after colorectal endoscopic submucosal dissection: a propensity-
score matching analysis
Version: 
0 
Date: 
13 Dec 2021
Reviewer's report:
I commend the author on the present study given the lack of guidance on post
ESD defect closure. 
-There are multiple grammatical errors, recommend review by a native English
speaker to assist the authors. Also recommend authors being careful making
categorical statements.
- Suggest changing the word 'high temperature' to fever and define fever in
methods.
- 'Although not confirmed, delayed perforation is proposed to be related to
excessive coagulation in the muscularis propria. ' Suggest removing 'although
not confirmed'. 
- 'hematochezia makes patientsfeel uneasy and may cause repeat
endoscopy', remove this line, just mention minor and major bleeding as adverse
events which may lead to hospitalization and repeat procedures.
- Page 4, line 41, specify that this data is for EMR, EMR RCTs do show benefit
of clip closure but only for >2cm right sided lesions, clarify this.
- Since clip closure was not performed on lesions where it was technically
challenging, then how is it the case that lesion size was similar between two
groups? I would expect clip closure group to have smaller lesions, please clarify
and mention in discussion.
- Define major and minor bleeding in methods. 
- The largest limitation of this study is in its methodology of being a
retrospective study. The larger lesions are more likely to not being closed and
larger the lesion, the more likely to develop adverse event. No degree of
propensity matching can completely remove the bias this introduces. Pleas
discuss this as the major limitation of the study.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes