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Comment & Response
June 9, 2021

Comments and Concerns on the LASER Trial—Reply

Author Affiliations
  • 1Gastroenterological Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
  • 2Transplantation and Liver Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
JAMA Surg. 2021;156(10):987. doi:10.1001/jamasurg.2021.2256

In Reply We are delighted that the Laparoscopic Elective Sigmoid Resection Following Diverticulitis (LASER) trial1 has generated discussion. First, we would like to thank Schultz et al for their excellent comments. We agree that the premature termination of the trial is a limitation, which was acknowledged in the original publication. The termination of trial followed strictly the prespecified termination criteria stated in the study protocol. Although we could have perhaps considered continuing the trial regardless, we want to remind readers that the recruiting had been ongoing for 4 years already at the time the trial hit midway. The inclusion criteria of the trial were chosen to cover the patient population that might be considered to be treated either conservatively or surgically. Similar inclusion criteria were also used in Diverticulitis Recurrences or Continuing Symptoms: Operative Versus Conservative Treatment (DIRECT) trial2 allowing future meta-analyses to be carried out effectively. Differences regarding Gastrointestinal Quality of Life Index (GIQLI) scores are explained by the fact that the mean differences in GIQLI scores are calculated only for patients who answered both baseline and 6-month questionnaires as stated in the Figure.1 We thank Schultz et al for proposing analyzing quality of life in more detail in future publications.

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