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Comment & Response
June 9, 2021

Comments and Concerns on the LASER Trial

Author Affiliations
  • 1Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
  • 2Department of Surgery, Skåne University Hospital Malmö, Malmö, Sweden
  • 3Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
JAMA Surg. 2021;156(10):984-985. doi:10.1001/jamasurg.2021.2247

To the Editor We read with great interest the article by Santos et al.1 We would like to congratulate the authors on this important study. A randomized clinical trial with few crossovers during the study period is challenging to perform in this setting and deserves respect. We have the following comments and questions to the authors.

We believe that this trial supports the most recent guidelines by the American and European colorectal societies, which encourage individualized decisions on elective surgery.4,5 As in previous trials, the lack of a sham procedure in the control group led most certainly to an overestimation of the effect size. Expectancy regarding sigmoid resection appears to be safe. Mainly patients with frequent recurrences impairing their quality of life should be candidates for resection because they probably benefit the most. In our opinion, the present trial does not support elective sigmoid resections in patients with persistent pain owing to the low number of inclusions in this group.

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