The 100 Most-Cited Articles in Visceral Surgery: A Systematic Review

Even though citation analysis has several limitations, it is a commonly used tool to determine the impact of scientific articles in different research fields.

The study aims to identify and systematically review the 100 most cited articles in the field of visceral surgery focusing on papers that modified therapeutic concepts and influenced the surgeons' decision making.

The 100 most cited clinical articles in visceral surgery were identified using Journal Citation Reports and Science Citation Index Expanded of the Web of Science (Thomson Reuters, Philadelphia, Pa., USA). Data for characterization of the articles were determined: Number of citations, research topic, journal, publication time, authorship, country of origin, type of article and level of evidence if reasonable.

The 100 most cited articles were published in 17 journals; 72 articles were found in the 3 journals: New England Journal of Medicine (38), Annals of Surgery (21) and Lancet (13). The oldest article was published in 1908 in Annals of Surgery (ranked 76th) and the most recent in 2012 in Lancet (65th). Eighty articles were published between 1990 and 2010. The number of citations ranged from 667 to 4,666 (median 925). The leading country of origin was the United States with 39 articles, followed by articles originating from more than one country (30). There were 45 interventional studies (27 randomized controlled trials), 32 observational studies, 19 reviews and 4 guidelines, definitions or classifications. The level of evidence was low (IV) in 42 articles and high in 35 articles (Ia or Ib). A high number of citations did not reflect a high level of evidence.

The topics and research questions of the identified articles covered a large area of visceral surgery. Some of the milestones in visceral surgery were identified. The high impact measured by citations did not reflect a high quality of research (level of evidence) in a considerable number of publications.