[Evidence-based surgery in colon carcinoma]

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