[Evidence-based surgical therapy: the significance of randomized controlled trials]

Evidence-based medicine supplies the information to solve clinical questions but there are specific problems of randomized controlled trials in surgery. First, placebo-controlled trials are need to determine the placebo effects, but patients sometimes refuse the placebo surgery. Furthermore, it remains difficult to decide on standard surgical procedures because the participating surgeons vary in skill and experience. However, randomized controlled trials are essential for the further development of a high-quality surgical standard.