The document discusses evidence-based best practices for colorectal surgery and postoperative care compared to more conventional approaches. It notes that traditional practices such as mechanical bowel preparation, prolonged preoperative fasting, vertical incisions, postoperative fasting, and delayed mobilization lack evidence of benefit and may cause harm. Evidence shows benefits to practices like no mechanical preparation, short preoperative fasting, laparoscopic access, early feeding and mobilization, and avoidance of nasogastric tubes and prolonged urinary catheters. The document argues these evidence-based approaches will likely become routine in colorectal surgery.

1. COLORECTAL SURGERY RETROSPECTIVE ANALYSIS ENRIQUE MONCADA. Colo-proctology Unit Dept. of Surgery H. Meixoeiro- CHUVI XVII Colo-proctology Course. Baiona February 2009

2. POSTOPERATIVE STAY IN COLORECTAL SURGERY Europe USA F-T/ERAS

9. MECHANICAL PREPARATION OF COLON Spain Roig JV Colorectal Dis 2008 Europe USA F-T/ERAS Kehlet JAmColSurg 2006

15. Laparoscopic colorectal surgery UK France Germany Italy Spain USA Kehlet el al. J Am Coll Surg .2006

18. Postoperative Nutrition: introduction of liquids. UK France Germany Italy Spain USA F-T/ERAS Kehlet JAm Coll Surg 2006

19. Postoperative Nutrition: First solid food UK France Germany Italy Spain USA F-T/ERAS Kehlet. J Am Coll Surg 2006

24. NGT in Spain 1996 2006 Roig JV. Cir Esp. 2008

27. Drains in Spain Routinary Selective Roig JV. Cir Esp. 2008

31. Surgical practice evidence based Ubbink DT Br J Surg 2004

32. ¿MEDICINE BASED ON EVIDENCE?

34. Eminence-based medicine.

35. Medicine based on vehemence

36. Surgeons are questioning the veracity and accuracy of the publications : “one thing is what has been published and another……”

39. Thank You