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Methodological challenges hampering a clear interpretation of these findings and understanding of true potential heterogeneity are discussed. BACKGROUND AND AIMS Although traditional transoral outlet reduction (TORe) involves argon plasma coagulation (APC) before endoscopic suturing, modified endoscopic submucosal dissection (ESD) has also been used. This study aims to evaluate the safety and efficacy of modified ESD-TORe in comparison with traditional APC-TORe. METHODS This was a retrospective study of prospectively collected data of pat