Sako T, Toyonaga T, Nakano Y, et al. - Researchers examined how resections involving the anal canal affect postoperative stricture development. Of 707 rectal lesions treated with endoscopic submucosal dissection (ESD) between April 2005 and October 2017, 102 lesions that required ≥ 75% circumferential resection were retrospectively examined in this study. Eighteen of 102 patients (17.6%) had development of post-ESD stricture. The multivariate analysis revealed the following factors to be correlated with the risk for postoperative strictures: circumferential resection ≥ 90% and ESD involving the anal canal (ESD-IAC). In addition, they identified correlation of anal strictures with a significantly greater frequency of obstructive symptoms and larger number of required dilation therapies relative to rectal strictures.