Abstract
In 1996, Richard Horton, Editor of The Lancet, provocatively compared surgical research to comic opera—a pointed comment about the glaring lack of randomised trials in surgery at that time.1 Fortunately, evidence-based surgery has progressed substantially since then. Many surgical procedures have been and are being assessed in high-quality studies,2–4 and hypothesis-generating, non-confirmatory case reports are being replaced by multicentre surgical trials.
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