Lesurtel 2005.

Methods	Randomised clinical trial. Generation of the allocation sequence: urn randomisation (adequate). Allocation concealment: sealed envelope (adequate). Blinding: inadequate. Incomplete outcome data addressed:adequate. Free from selective reporting: adequate. Free from baseline imbalance bias: adequate. Free from early stopping bias: adequate.Free from sponsor bias: inadequate.
Participants	Country: Switzerland. Number randomised: 100. Mean age: 56 years. Females: 47(47%). Major liver resection: 61(61%). Chronic liver disease: not stated. Cirrhosis: none. Inclusion criteria > 2 segments Benign or malignant tumours Platelet count > 100000/ml. Prothrombin activity >60%. Exclusion criteria Cirrhotic. Cholestatic (serum bilirubin > 100 mumol/L).
Interventions	Participants were randomly assigned to four groups. Group 1: CUSA (n = 25) Group 2: Hydrojet (n = 25) Group 3: RFDS (n = 25) Group 4: Clamp‐crush (n = 25). Co‐interventions Vascular occlusion: no inflow occlusion unless significant bleeding preventing selective coagulation or ligation of small structures. In the clamp‐crush group, PTC was used routinely. Low CVP: yes (0‐5mmHg). Hypoventilation: not stated. IV agents to decrease blood loss: not stated. Management of raw surface: < 2 mm coagulated, bigger vessels, bile ducts ligated.
Outcomes	The main outcome measures were peri‐operative mortality, peri‐operative morbidity, blood loss and transfusion requirements, liver function tests, transection speed, stay, and costs.
Notes	Authors provided information on allocation sequence generation; and questions related to morbidity and liver enzymes in December 2006.
Risk of bias
Bias	Authors' judgement	Support for judgement
Adequate sequence generation?	Low risk	A ‐ Adequate ("The generation of the randomisation sequence was performed with sealed envelopes using urn randomisation")
Allocation concealment?	Low risk	A ‐ Adequate ("The generation of the randomisation sequence was performed with sealed envelopes using urn randomisation")
Blinding? All outcomes	High risk	C ‐ Inadequate
Incomplete outcome data addressed? All outcomes	Low risk	A ‐ Adequate Review authors' comment: No post‐randomisation drop‐outs.
Free of selective reporting?	Low risk	A ‐ Adequate Review authors' comment: All the important outcomes were reported.
Free of baseline imbalance bias?	Low risk	A ‐ Adequate
From from early stopping bias?	Low risk	A ‐ Adequate Review author comment: The sample size calculations were reported and the calculated number of patients were recruited.
Free from academic bias?	Low risk	A ‐ Adequate Review author comment: No previous publication or conference report of a similar trial by the trial author was identified.
Free from sponsor bias?	High risk	C ‐ Inadequate ("The authors thank Tyco Healthcare (Mansfield, MA), Erbe (Tubingen, Germany), and TissueLink (Dover, NH) for their sponsorship")