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.

致编辑我们非常感兴趣地阅读了 Santos 等人的文章。¹我们要祝贺作者完成这项重要的研究。在研究期间很少交叉的随机临床试验在这种情况下具有挑战性，值得尊重。我们对作者提出以下意见和问题。

我们认为，该试验支持美国和欧洲结直肠学会的最新指南，该指南鼓励个体化决定择期手术。^{4 ,5}与之前的试验一样，对照组缺乏假手术肯定会导致效应大小的高估。乙状结肠切除术的预期似乎是安全的。主要是频繁复发影响其生活质量的患者应该是切除的候选者，因为他们可能受益最多。我们认为，本试验不支持对持续性疼痛患者进行选择性乙状结肠切除术，因为该组的纳入数量较少。