Clinical significance of the muscle-retracting sign during XXXX .

@entity5 @entity1 @entity14 @entity1313
BACKGROUND AND STUDY AIMS: During @entity14 (ESD), the feature of a muscle layer being pulled toward a @entity5 is sometimes detected. We call this feature the muscle-retracting sign (MR sign). The aim of this study was to evaluate whether the MR sign is associated with particular types of @entity1313 and whether it has any clinical significance for ESD sessions. @entity1 AND METHODS: A total of 329 @entity1 underwent ESD for 357 @entity14 . The frequency of positivity for the MR sign was evaluated in different morphologic and histopathologic types of @entity5 . The success rate of complete resection and the incidence of complications were also evaluated according to whether lesions were positive or negative for the MR sign. RESULTS: The rates of positivity for the MR sign in the various lesion types were as follows: laterally spreading tumor-granular nodular mixed type (LST-G-M), 9.6%; laterally spreading tumor-granular homogeneous type (LST-G-H) and laterally spreading tumor-nongranular type (LST-NG), 0%; sessile type, 41.2%. The resection rate was 100% (329/329) in lesions negative for the MR sign; however, it was 64.3% (18/28) in lesions positive for the MR sign, which was significantly lower (P<0.001). CONCLUSIONS: The MR sign was present only in some protruding lesions, and more importantly, it was associated with a high risk of @entity5 removal by ESD. Our data indicate that lesions positive for the MR sign lesions should be dissected with great caution; alternatively, based on the features of the individual case, a switch to surgery should be considered for the benefit of the @entity1 .
