Background/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is performed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing perforation. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of rescue hybrid ESD (RH-ESD). Methods: We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group (SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes. Results: Resection time was significantly shorter in the following order: RH-ESD (149 [90–197] minutes) >C-ESD (90 [60–140] minutes) >SH-ESD (52 [29–80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dissection rate was significantly lower in the piecemeal resection group (25% [20%–30%]) than in the en bloc resection group (40% [20%–60%]). Conclusions RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoiding surgery.

Ultraviolet (UV)-induced wrinkle and pigmentation are very common in clinical practice. In this report, we presented the case of a 58-year-old man who developed wrinkle and pigmentation around right hand, face and neck for ten years. Coix-seed Reactive Derivatives (CRD) was administrated orally 2.1g twice a day for 6 months. These lesions were improved in the third month, and a dramatic response was obtained at the end of 6 months of treatment. Further research is needed to define the optimal dose and duration of CRD intake.

Friction melanosis is a cutaneous entity characterized by a brownish pigmentation distributed on the skin over bony regions of various sites including a trunk or the limbs, after the use, for many years, of a nylon towel or scrub brush to clean the skin. Moreover, repeated trauma due to friction of clothes on the skin over bony prominences are another factors characterizing its pathogenesis. In this report, we presented the case of a 58-year-old man who developed severe friction melanosis around both knees and lower extremities for about 20 years. Coix-seed Reactive Derivatives (CRD) was administrated orally 2.1g twice a day for 6 months. The lesions of pigmentation diminished markedly within 3 months. Further research is needed to define the optimal dose and duration of CRD intake against friction melanosis.