Transanal Total Mesorectal Excision has been Suspended in Norway


Featured Article

Wasmuth H. H, Færden A. E,  Myklebust T. Å,  Pfeffer F, Norderval S,  Riis R, Olsen O. C et al.  Transanal total mesorectal excision for rectal cancer has been suspended in Norway. BJS 2019; 107: 121-130.

Expert Reviews

Methodological Reviewer:  Erin Kennedy MD, Head of General Surgery, Mount Sinai Hospital

Clinical Reviewer: Carl Brown MD M.Sc FACS FRCSC, Head of General Surgery, St. Paul’s Hospital

Clinical Reviewer: Philip B. Paty MD, Colorectal Surgeon, Memorial Sloan Kettering Cancer Center



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Supplementary Articles

Thoma A, Kaur M.N, Farrokhyar F, Waltho D, Levis C, Lovrics P, Goldsmith C.H.  Users’ guide to the surgical literature: how to assess an article about harm in surgery. Can J Surg; 2016; 59(5):351-357.


Please read the above articles and be prepared to discuss the following:

  1. What is the clinical question being addressed?
  2. What is the rationale for the study?
  3. What is the study design?
  4. Was the assignment of patients to treatment randomized?
  5. Were all the patients who entered into the trial properly accounted for and attributed at its conclusion?
  6. Did the sample include an appropriate spectrum of patients and were groups similar at baseline?
  7. Were the methods for performing the test described in sufficient detail to permit replication?
  8. Aside from the experimental intervention, were the groups treated equally?
  9. Were all clinically important outcomes considered?
  10. How large and precise was the treatment effect?
  11. Are the likely benefits worth the potential harm and costs?
  12. Will the reproducibility of the test result and its interpretations be satisfactory in my setting?
  13. State the conclusion. Have the authors addressed the clinical question posed?
  14. Does the evidence support the conclusion?