[Evidence based surgery has some limitations]

Evidence based medicine can be defined as the application of the best evidence in the care of a given patient. When applied to surgical practice, it appears that this concept has some limitations. To discuss these limitations, the authors made the choice to discuss the terms the original definition. Some factors are related to the paucity and the poor quality of randomized controlled trials and meta-analyses in surgery, to the difficulties to appraise the surgical publications and apply the results of randomized trials to a given patient, and to bring the surgeons more willing to endorse the principles of evidence-based medicine. But all these limitations could be overcome making evidence-based surgery not to be a simple passing fad but a formal paradigm.