[Principles of evidence-based medicine in the surgical treatment of colorectal cancers].
The principles of evidence-based medicine (EBM) are summarized. The surgical activity of the author's team is analysed to answer the question of whether the principles of EBM prevail in their surgical treatment of colorectal cancer. Results of some comparative studies are presented as concerns preoperative preparation, antibiotic prophylaxis, and the development of the suture technique applied. The changes of radicality in the surgery of colorectal cancer are discussed. It is emphasized that three newly developed procedures are routinely used in their practice to enhance surgical radicality and to improve the 5-year survival rate: 1. subtotal colectomy for obstructive left side colonic tumours, 2. total mesorectal excision for middle and lower third rectal cancer, and 3. multivisceral resections for the treatment of advanced colorectal tumours. The advantages of new methods recently introduced in Hungarian colorectal surgery are guaranteed by previous published studies. The team has made efforts to develop new methods and to control the results in routine surgery. Only the surgical practice during the past few years could be influenced by the principles of EBM, but even so the maintenance of surgical standards, the application of results of well-documented reliable studies and efforts to develop new and better methods reflect principles equivalent to those of EBM in colorectal surgery in the past two decades.
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Szegedi Tudományegyetem, Altalános Orvostudományi Kar, Szent-Györgyi Albert Orvostudományi.
D019072:Antibiotic Prophylaxis; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D019317:Evidence-Based Medicine; D006801:Humans; D006814:Hungary; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D013536:Suture Techniques; D016896:Treatment Outcome