Evidence-based surgery of colon carcinoma

Only a few therapeutic approaches in colon cancer therapy are based on cont rolled study results. Via an internet search using different search strateg ies 965 abstracts written about colon cancer therapy between 1980-2000 were analysed. Studies focussing on adjuvant therapy were not included. We foun d 446 retrospective, 150 prospective randomized, 151 prospective non-random ized studies and 218 review articles. Controlled study results as a scienti fic base are available for perioperative antibiotic prophylaxis (127 prospe ctive randomized studies), mechanical intestinal cleansing (n = 5), a simil ar efficacy of stapler and hand-made anastomosis (n = 15), and the early on set of a stage-adjusted nutrition (n = 3). Our internet search shows that o nly a minor fraction (approximately 10 %) of colon surgery is evidence base d. The most important prerequisites for an appropriate surgical resection a re the pathology results reflecting the degree of tumor spreading. Besides the data from controlled studies we have to take the results from prospecti ve multi-center studies in consideration.