Research Priorities

A running punch list of studies/guidelines worth ingesting next, generated 2026-08-19 by sweeping the "Open items / gaps" section of every wiki page. Organized by how actionable each gap is, not by folder. Check items off (and link the new source page) as they're ingested; re-sweep periodically as new gaps get flagged during ingests and lints.

High-priority named studies

These resolve a specific gap the wiki has already identified — highest value per ingest.

Rectal cancer / TNT (see Rectal Cancer, Total Neoadjuvant Therapy (TNT))

• [x] POLISH II — ingested 2026-08-20, see Ciseł 2019 - POLISH II Long-Term Results. Result: a genuinely neutral trial (no efficacy benefit or locoregional trade-off in either direction).
• [x] RAPIDO 5-year follow-up (Dijkstra et al., Ann Surg 2023) — ingested 2026-08-20, see Dijkstra 2023 - RAPIDO 5-Year Locoregional Failure. Resolved the previously-unresolved locoregional-recurrence disagreement: RAPIDO's local-control trade-off is now confirmed statistically significant (10.2% vs 6.1% LRR, P=0.027) and RAPIDO-specific — not replicated in PRODIGE 23, STELLAR, or POLISH II.
• [ ] IDEA duration collaboration — currently only textbook-sourced (Sabiston), not independently ingested.
• [x] JANUS and NORAD01-GRECCAR16 protocols ingested 2026-08-20 — see Alvarez 2024 - JANUS Trial Protocol and Brouquet 2020 - GRECCAR16 Trial Protocol. Both still accruing/awaiting results — re-check for published outcomes in a future ingest.
• [ ] ACO/ARO/AIO-18, GRECCAR 14 — still referenced only secondhand (Boublikova review and PRODIGE 23's discussion, respectively); protocols or results not yet ingested.
• [ ] OPRA trial (Garcia-Aguilar et al.) — referenced by name (not ingested) in Total Neoadjuvant Therapy (TNT), Alvarez 2024 - JANUS Trial Protocol, and Boublikova 2023 - TNT in Rectal Cancer Review as the key primary data point for the pCR/non-operative-management-success dissociation — load-bearing to the NOM discussion but only known secondhand. Flagged in the 2026-08-20 lint pass.

Neuroendocrine tumors (see Small Bowel Neuroendocrine Tumors (NETs))

• [ ] TELESTAR — telotristat-etiprate for carcinoid syndrome; currently textbook-only (35% reduction in daily bowel movements figure is unverified against primary data).
• [ ] RADIANT-2 — everolimus + octreotide in functioning NETs (distinct from the already-ingested RADIANT-4).

Diverticulitis (see Diverticulitis, SCANDIV Trial)

• [ ] DILALA — referenced repeatedly in SCANDIV's and the Ladies trial's own discussions, never independently ingested.
• [ ] LapLAND — same as above.
• [ ] SCANDIV 90-day report (Schultz 2015, JAMA) and 1-year report (Schultz 2017, BJS) — to see how the recurrence/reoperation gap develops over time relative to the 5-year data already in.

Peritoneal disease / HIPEC (see Cytoreductive Surgery and HIPEC)

• [x] PRODIGE 7 (primary publication) — ingested 2026-08-20, see Quénet 2021 - PRODIGE 7 Trial. Confirmed no OS/RFS benefit from adding HIPEC to CRS, plus new detail (significantly more morbidity at 60 days with HIPEC) not previously in the wiki.
• [ ] COLOPEC — still only known via a secondary review's summary.
• [ ] Mitomycin-vs-oxaliplatin RCT — same.

Small bowel adenocarcinoma (see Small Bowel Adenocarcinoma)

• [ ] BALLAD — no standard adjuvant protocol is documented pending this.

IBD (see Crohn Disease, Ulcerative Colitis)

• [ ] Crohn's-specific ACG guideline — only the UC-specific ACG 2025 guideline is ingested so far (BSG 2025 - IBD Guidelines (Adults) covers Crohn's broadly, but not to ACG's depth). ASCRS Ch46 - Medical Therapy for Crohn's Disease (2026-08-25) supplies a comparative summary table of AGA 2013/ACG 2018/ECCO 2020 Crohn's guideline recommendations by induction-vs-maintenance and disease severity, but this is a textbook's secondary crosswalk, not primary ingestion of any of the three — the gap stands.
• [ ] Crohn's-specific AGA guideline — same gap, AGA side; same Ch46 crosswalk caveat applies.

• [ ] VARSITY trial (vedolizumab vs. adalimumab head-to-head) — the one real head-to-head data point ACG 2025 - Ulcerative Colitis Guideline, AGA 2024 - Moderate-to-Severe UC Pharmacotherapy Guideline, and (as of 2026-08-25) ASCRS Ch45 - Medical Management of Ulcerative Colitis all lean on for UC drug positioning, with identical numbers across all three (31.3% vs 22.5% clinical remission, 39.7% vs 27.7% endoscopic improvement at week 52) — but still known to the wiki only via secondary paraphrase, never as its own primary source. Flagged in the 2026-08-20 lint pass.

• [ ] Kono-S anastomosis RCT — the first published RCT confirming lower endoscopic/clinical recurrence vs. conventional anastomosis in Crohn's ileocolic resection is currently known to the wiki only via ASCRS Ch48 - Crohn's Disease Surgical Management's secondary summary (see Anastomotic Construction for the fuller trial-evidence writeup) — not yet ingested as a primary source, despite being the single most load-bearing trial behind this wiki's Kono-S content.

• [ ] Regueiro postop-infliximab RCT and the PREVENT trial — cited by ASCRS Ch48 - Crohn's Disease Surgical Management (see Crohn Disease's "Postoperative recurrence-prevention trial evidence") as showing a genuine gap between the two trials' primary conclusions (Regueiro strongly positive on endoscopic recurrence; PREVENT missed its clinical- recurrence primary endpoint despite lower endoscopic scores) — both known only secondhand; worth independently ingesting to confirm the size and interpretation of that gap.
• [ ] PUCCINI study (preoperative anti-TNF safety in IBD abdominal surgery, 955 patients) — the key prospective data point ASCRS Ch49 - Ulcerative Colitis Surgical Management leans on for "preoperative biologics don't independently mandate staged IPAA" on Ileal Pouch-Anal Anastomosis (IPAA), known to the wiki only via this one secondary summary.
• [ ] 343-patient French IRA-failure study — cited on Ulcerative Colitis with a flagged, unresolved internal inconsistency (colectomy-for-severe-acute-colitis named as both a failure predictor and, elsewhere in the same chapter, associated with decreased failure risk); independently ingesting the primary study would resolve which reading is correct.
• [ ] Remzi redo-pouch series (>500 patients) — the key outcome data ASCRS Ch50 - Complications of the Pelvic Pouch leans on for pouch-revision-vs-excision decision-making on Ileal Pouch-Anal Anastomosis (IPAA) (53% complication rate, 90%/82% 5-/10-year pouch survival after redo), known to the wiki only via this one secondary summary.
• [ ] >3000-patient pouch-neoplasia cohort — the source of the cumulative dysplasia (0.8%/2.2% at 5/20yr) and cancer (0.2%/0.4%/2.4% at 5/10/20yr) incidence figures on Ileal Pouch-Anal Anastomosis (IPAA)'s new "Neoplasia of the pouch" section, cited by ASCRS Ch50 - Complications of the Pelvic Pouch only secondhand.

Infectious colitis (see Infectious Colitis)

• [ ] Current IDSA/SHEA C. diff guideline — the antibiotic table in the wiki is currently just the textbook's paraphrase of it.
• [ ] Zar 2007 RCT (vancomycin vs. metronidazole for mild/severe CDI, 150 patients) — the key trial behind the wiki's "vancomycin for severe CDI" recommendation (97% vs. 76% cure rate, p=0.02), known to the wiki only via ASCRS Ch52 - Clostridium difficile Infection's secondary summary.
• [ ] Neal 2011 (landmark diverting-loop-ileostomy-for-fulminant-CDI study, 42 patients vs. historical colectomy controls) — the foundational study behind the colon-sparing surgical alternative described on Infectious Colitis, known only secondhand.
• [ ] EAST 2017 multicenter study (10 centers, colectomy vs. diversion for fulminant CDI) — the propensity-weighted mortality benefit for diversion (17.7% vs. 39.7%, p=0.002) is a genuinely load-bearing but methodologically caveated finding (the study couldn't identify each center's actual selection criteria) that would benefit from primary-source scrutiny.
• [ ] EXTEND trial (364 patients, vancomycin vs. extended-pulse fidaxomicin) — cited for fidaxomicin's 11% clinical-cure improvement over vancomycin, known only via Ch52's summary.
• [ ] Cochrane review, CDI antibiotics (22 studies, 3,215 patients) — the source of the vancomycin > metronidazole, fidaxomicin > vancomycin ranking now on Infectious Colitis; worth reading directly given the review's own caveat that the differences "were not too large."

Microscopic and ischemic colitis (see Microscopic Colitis, Ischemic Colitis)

• [ ] Miehlke budesonide RCT (57 patients, budesonide vs. mesalamine vs. placebo) — the primary trial behind Microscopic Colitis's "budesonide is the evidence-based mainstay" claim (68% vs. 21%/26% success), known to the wiki only via ASCRS Ch53 - Radiation, Microscopic, and Ischemic Colitis's secondary summary.
• [ ] Münch budesonide maintenance RCT (110 patients induced, responders randomized to budesonide 4.5mg/day vs. placebo) — the key data point for maintenance therapy (61% vs. 16% remission at 1 year) on Microscopic Colitis, known only secondhand.
• [ ] Spanish Microscopic Colitis Group consensus statement (Fernandez-Banares) — the source of the diagnostic criteria now used on Microscopic Colitis and of several of its quantified risk-factor ORs (NSAIDs, PPIs, smoking, polyarteritis); worth reading directly given how much of the page's risk-factor section leans on this one document.
• [ ] Higgins epidemiology review — the source of Ischemic Colitis's subgroup-specific incidence figures (general population 4–9/100,000; COPD up to 100/100,000, RR 2.6–4.3), known to the wiki only via Ch53's secondary summary.
• [ ] Iacobellis CT-accuracy study (130 patients undergoing CT for suspected IC) — the source of the load-bearing "100% CT-positive in the acute phase" and ">70% mortality with pneumatosis + necrosis" figures on Ischemic Colitis, known only secondhand.
• [ ] Scharff surgical-outcome study — corroborates but doesn't independently confirm the up-to-40% operative mortality figure on Ischemic Colitis; worth reading directly given how consequential this figure is to surgical decision-making.

IBS and functional pelvic pain (see Irritable Bowel Syndrome (IBS), Functional Anorectal Pain & Coccygodynia, Pudendal Neuralgia)

• [ ] Ford et al. 2018 ACG monograph on IBS management — the field's central evidence synthesis, underlying much of Irritable Bowel Syndrome (IBS)'s treatment-ladder claims; known to the wiki only via ASCRS Ch56 - Functional Disorders After Colorectal Surgery-IBS's secondary summary.
• [ ] Black et al. 2020 secretagogue network meta-analysis — the source of Irritable Bowel Syndrome (IBS)'s "similar efficacy across lubiprostone/linaclotide/ plecanatide" claim, made only via indirect/network comparison since no head-to-head RCT exists.
• [ ] Chiarioni et al. 2010 (157-patient RCT, biofeedback vs. EGS vs. digital massage for levator ani syndrome) — the primary trial behind Functional Anorectal Pain & Coccygodynia's "biofeedback is superior" claim (94%/97% success on relaxation/balloon-expulsion outcomes), known only secondhand.
• [ ] Robert et al. 2005 RCT (32 patients, pudendal nerve decompression/transposition vs. nonsurgical treatment) — the only RCT-level evidence behind Pudendal Neuralgia's operative decompression recommendation; worth reading directly given how much of the surgical section otherwise rests on case series.
• [ ] Kleimeyer et al. 2017 (109-patient retrospective cohort, coccygectomy vs. nonoperative care, 4-year follow-up) — the source of Functional Anorectal Pain & Coccygodynia's coccygectomy-superiority claim, known only via Ch56's secondary summary.

Constipation medical management (see Constipation)

• [ ] Johanson et al. 2008 RCT (multicenter, 4-week, double-blind, placebo-controlled) — the primary trial behind Constipation's lubiprostone-beats-placebo claim, known to the wiki only via ASCRS Ch58 - Evaluation of Constipation and Treatment of Abdominal Component's secondary summary.
• [ ] Lembo et al. 2011 (two randomized trials of linaclotide for chronic constipation, NEJM) — the primary evidence behind linaclotide's inclusion in Constipation's secretagogue ladder, known only secondhand.
• [ ] Miner et al. 2017 phase III RCT (plecanatide for chronic idiopathic constipation) — the primary trial behind plecanatide's addition to Constipation's secretagogue ladder, an entirely new agent to the wiki via Ch58.
• [ ] Camilleri et al. 2016 integrated analysis (6 RCTs, 2,484 patients with functional constipation) — the primary evidence behind Constipation's prucalopride claim (superior to placebo for ≥3 spontaneous bowel movements/week), known only via Ch58's secondary summary.
• [ ] Luthra et al. 2018 network meta-analysis (27 RCTs, PAMORAs for opioid-induced constipation) — the source of Constipation's "naloxone and naldemedine most efficacious, naloxone safest" claim for OIC management, worth reading directly given how consequential this is for a growing patient population.

Obstructed defecation syndrome treatment (see Obstructed Defecation Syndrome (ODS), Constipation, Rectocele)

• [ ] Rao et al. 2018 RCT (Lancet Gastroenterol Hepatol, home-based vs. office-based biofeedback for constipation with dyssynergic defecation) — the primary trial behind Constipation's claim that home-based biofeedback is non-inferior to office-based therapy, known to the wiki only via ASCRS Ch59 - Treatment of Difficult-Obstructive Defecation's secondary summary.
• [ ] Faried et al. 2010 prospective randomized study (J Gastrointest Surg, surgical vs. non-surgical treatment of anismus in obstructed defecation) — cited by Ch59 in the puborectalis myomectomy discussion; worth reading directly since it's the only comparative (surgical vs. non-surgical) trial cited anywhere in the dyssynergic-defecation treatment ladder.
• [ ] Van Geluwe et al. 2014 meta-analysis (Acta Chir Belg, STARR for obstructed defecation syndrome) — the primary synthesis behind Rectal Prolapse Repair/Rectocele's STARR recurrence/decline-in-Europe claims, known only secondhand via Ch59.
• [ ] Nugent et al. 2020 (Tech Coloproctol, botulinum toxin A vs. electrogalvanic stimulation for levator ani syndrome) — cited by Ch59 for EGS technique/dosing detail, but its actual subject is levator ani syndrome (see Functional Anorectal Pain & Coccygodynia) rather than dyssynergic defecation — worth reading directly to confirm which condition its head-to-head comparison data actually applies to before leaning on it further for either page.
• [ ] Grimes et al. 2019 systematic review (Int Urogynecol J, surgical interventions for posterior compartment prolapse and obstructed defecation symptoms, with clinical practice recommendations) — the broadest comparative synthesis across rectocele/enterocele repair approaches cited anywhere in the wiki; would meaningfully firm up Rectocele's and Obstructed Defecation Syndrome (ODS)'s "no head-to-head RCT" gaps if read directly.

Rectal prolapse repair technique (see Rectal Prolapse Repair, Rectal Prolapse (Procidentia))

• [ ] Hidaka et al. (double-blind RCT, 6-year follow-up, laparoscopic suture rectopexy vs. laparoscopic ventral mesh rectopexy) — the primary trial behind Rectal Prolapse Repair's headline recurrence comparison (23.3% vs. 8.2%) between the two most-discussed abdominal techniques; known to the wiki only via ASCRS Ch60 - Rectal Prolapse's secondary summary.
• [ ] Evans et al. (multicenter collaboration, 2,203 patients, mesh erosion after laparoscopic ventral mesh rectopexy) — the largest safety dataset cited anywhere in the rectal-prolapse content, load-bearing for the mesh-type/erosion-rate claims on Rectal Prolapse Repair.
• [ ] Fang et al. (ACS NSQIP analysis, perineal vs. abdominal rectal prolapse repair mortality in high-risk (ASA 3–4) patients) — the primary evidence behind Rectal Prolapse Repair's approach-selection guidance for elderly/frail patients, known only secondhand.
• [ ] Gurland et al. (ventral mesh rectopexy outcomes after prior prolapse surgery vs. as primary repair) — the source of Rectal Prolapse Repair's "25% vs. 9.7% at 5-year follow-up" recurrent-prolapse counseling data; worth verifying directly given how consequential it is for patient counseling after a failed prior repair.
• [ ] Altomare et al. (Tech Coloproctol, pelvic floor function following ventral rectopexy vs. STARR for obstructed defecation) — the only head-to-head comparison cited between two of Obstructed Defecation Syndrome (ODS)'s major internal-prolapse treatment options; bridges the Ch59/Ch60 content and would help resolve the "no head-to-head RCT" gap on both pages.

Fecal incontinence treatment (see Fecal Incontinence)

• [ ] Wexner et al. (Ann Surg 2010, 120-patient prospective multicenter US trial) — the FDA- approval trial behind Fecal Incontinence's sacral neuromodulation outcome data (83% ≥50% reduction at 1 year, 41% complete continence), known to the wiki only via ASCRS Ch61 - Fecal Incontinence Evaluation and Treatment's secondary summary.
• [ ] Graf et al. (Lancet 2011, randomized sham-controlled trial of NASHA Dx) — the largest RCT behind Fecal Incontinence's bulking-agent claim (52% vs. 31% treatment success), worth reading directly given how consequential the P = 0.0089 result is for an office-based option.
• [ ] Knowles et al. (CONFIDeNT trial) (Lancet 2015, double-blind sham-controlled PTNS RCT, 227 patients) — the primary trial behind Fecal Incontinence's "no significant difference vs. sham at 12 weeks" PTNS finding, a negative result worth verifying directly given how it contradicts earlier uncontrolled PTNS series.
• [ ] Visscher et al. (Dis Colon Rectum 2017, sham-controlled RCT of SECCA radiofrequency) — the source of Fecal Incontinence's "statistically significant but only 2/40 patients met clinically-relevant-improvement threshold" nuance, load-bearing for the ASCRS CPG's cautious SECCA recommendation.
• [ ] Samaranayake et al. (Colorectal Dis 2010, systematic review of ventral rectopexy for rectal prolapse and intussusception) — the source of Fecal Incontinence's "45% FI score decrease" VMR outcome claim, distinct from (and worth cross-checking against) the Ch60-sourced VMR outcome figures already on Rectal Prolapse Repair.

LARS treatment and prediction (see Low Anterior Resection Syndrome (LARS))

• [ ] Battersby et al. (POLARS nomogram derivation/validation) — the primary source behind Low Anterior Resection Syndrome (LARS)'s preoperative-prediction section, known to the wiki only via ASCRS Ch62 - Low Anterior Resection Syndrome's secondary summary; consequential for the informed-consent/colostomy-discussion guidance built on top of it.
• [ ] van der Heijden et al. (postoperative systematic LARS screening/treatment protocol study) — the source of the "mean LARS score 31→18, major-LARS rate 51.9%→26.3%" figures opening Low Anterior Resection Syndrome (LARS)'s Treatment section; worth verifying the protocol details directly given how strong the effect size is.
• [ ] Andreyev et al. (algorithmic-care RCT for pelvic radiation/LARS-type bowel symptoms) — cited alongside the protocol study above as evidence that structured, algorithm-driven care outperforms routine ad hoc management regardless of which specialty delivers it.
• [ ] Huang & Koh (systematic review of sacral neuromodulation for LARS) — the source of Low Anterior Resection Syndrome (LARS)'s "94 screened, 79.8% implanted, 67.0% median LARS-score improvement" SNM figures, which the page currently retains alongside (rather than reconciled with) the older Ch29-sourced SNS figures; reading this directly would help determine whether the two figure sets can be merged.
• [ ] An RCI-vs-PTNS RCT (37 patients, cited in ASCRS Ch62 - Low Anterior Resection Syndrome for the retrograde colonic irrigation subsection) — author not confidently identified from the extracted text; worth tracking down given RCI is now a first-class LARS treatment option on the wiki with no independently-ingested primary source.

Pelvic organ prolapse (anterior/middle compartment) (see Pelvic Organ Prolapse (Anterior & Middle Compartment))

• [ ] Wu et al. (lifetime-risk projection for POP/SUI surgery, and the ≥46% by-2050 symptomatic-POP increase estimate) — the source of this page's "12.6% lifetime surgical risk by age 80" figure and its 2050 projection, known to the wiki only via ASCRS Ch65 - Middle and Anterior Pelvic Compartment Issues for the Colorectal Surgeon's secondary summary; the chapter itself notes the projection may be an overestimate.
• [ ] The CARE trial (Nygaard et al., Colpopexy and Urinary Reduction Efforts) — the primary source of this page's "10.5% overall mesh erosion rate" and large-pore-polypropylene-preference finding for sacrocolpopexy; load-bearing for current mesh-selection practice.
• [ ] The OPTIMAL trial (Barber et al., comparison of two transvaginal apical suspension approaches plus perioperative behavioral therapy) — cited for apical vaginal prolapse technique comparison; worth reading directly given the trial's own published corrections (JAMA 2014;311:1023-1034) suggest some care is needed with its figures.
• [ ] Chughtai et al. (mesh-infection risk by procedure combination) — the source of this page's "OR 2.13 for combined vaginal sling + sacrocolpopexy mesh" finding, which the page also connects to an analogous VMR+posterior-colporrhaphy mesh-infection finding on Rectal Prolapse Repair; worth verifying whether the two findings are as directly comparable as the chapter implies.
• [ ] Watadani et al. (Dis Colon Rectum 2013, sacrocolpopexy with rectopexy outcomes) — the source of the TAPE-score combined-surgery outcome figures cited on both this page and Rectal Prolapse Repair's ventral mesh rectopexy section; the single most load-bearing study for this wiki's multidisciplinary-surgery guidance.

Pediatric colorectal disorders (see Pediatric Colorectal Disorders)

• [ ] Hintz et al. (J Pediatr Surg 2019, systematic review and meta-analysis of sclerotherapy for pediatric rectal prolapse) — the source of this page's agent-specific cure-rate figures (saline, phenol, ethanol), known to the wiki only via ASCRS Ch66 - Pediatric Colorectal Disorders's secondary summary.
• [ ] Kenny et al. (double-blind RCT of topical GTN for pediatric anal fissure) — the one of three cited GTN trials finding no benefit over placebo (84% healing in both arms), conflicting with two other cited trials showing clear benefit; worth reading directly to understand the discrepancy given all three are described as double-blind RCTs.
• [ ] Afsarlar et al. (Pediatr Surg Int 2011, clinical characteristics/management/outcome of perianal abscess and fistula-in-ano in children) — a key source behind this page's pediatric perianal-sepsis epidemiology and the "genuinely unsettled management" framing.
• [ ] Christison-Lagay et al. (Pediatrics 2007, nonoperative management of perianal abscess in infants associated with decreased fistula risk) — the primary evidence behind this page's shift toward nonoperative-first management in young children; a genuinely practice-changing finding worth verifying directly.

Geriatric colorectal surgery (see Geriatric Considerations in Colorectal Surgery)

• [ ] Minnella et al. (Acta Oncol 2019, impact of improved functional capacity before surgery on postoperative complications in colorectal cancer) — the source of this page's finding that patients with poor baseline walking capacity benefit most from multimodal prehabilitation; load-bearing for the prehabilitation-targeting recommendation.
• [ ] GOSAFE study (Montroni et al., Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery, 977 patients with a 440-patient colorectal-specific subgroup analysis) — the source of this page's Clavien-Dindo-to-functional-decline correlation; a large prospective international study worth reading directly rather than relying on this chapter's secondary summary.
• [ ] Shahrokni et al. (geriatric comanagement mortality comparison, 1,009 vs. 846 patients) — the primary evidence for this page's geriatric-comanagement postoperative-outcome claim.
• [ ] Zattoni et al. (J Am Geriatr Soc 2019, fTRST validation for emergency general surgery) — the source of this page's claim that the fTRST is validated specifically in the emergency department setting, a distinct use-case from the elective-setting tools covered elsewhere in this wiki.
• [ ] Hshieh et al. (JAMA Intern Med 2015, meta-analysis of multicomponent nonpharmacological delirium interventions) — the source of this page's OR 0.47 delirium-reduction figure; worth verifying directly given how specific and load-bearing the effect size is.
• [ ] Montroni et al. (Eur J Surg Oncol 2018, personalized management of elderly patients with rectal cancer — 29-member interdisciplinary task force recommendations) — the primary source behind this page's entire Personalized Treatment of Rectal Cancer section (Table 67.2 general recommendations, Fig 67.3 treatment algorithm); the single most load-bearing citation in this chapter and a strong candidate for direct reading given how much of the page's actionable guidance (e.g., "adjuvant chemotherapy not advised in geriatric patients") traces to it alone.

Condition pages with zero primary literature

Entire pages still built solely from the Sabiston textbook chapters — good candidates for a ground-up strengthening rather than chasing one citation.

• [ ] Appendiceal Neoplasms — MAN/PMP, GCA, colonic-type, and signet-ring subtypes (the NET systemic-therapy piece was updated in the 2026-08-19 lint pass; the other four subtypes are still textbook-only).
• [ ] Gastrointestinal Stromal Tumors (GIST) — imatinib RCTs, risk-stratification validation.
• [ ] Short Bowel Syndrome — teduglutide trials, growth hormone meta-analysis, intestinal transplant survival data.
• [ ] Radiation Enteritis — the glutamine RCT and other prevention agents cited.
• [ ] Enterocutaneous Fistula — octreotide RCTs, fistuloclysis technique, spontaneous-closure retrospective data.
• [ ] Meckel Diverticulum — the incidental-finding malignancy-incidence controversy is explicitly flagged as a good candidate if Stephen wants to dig deeper.
• [x] Rectal Prolapse (Procidentia) / Rectal Prolapse Repair — now has extensive comparative repair-technique outcome data via ASCRS Ch60 - Rectal Prolapse (see the "Rectal prolapse repair technique" studies above); still no independently-ingested primary source for any individual study.
• [ ] Solitary Rectal Ulcer Syndrome (SRUS) — medical therapy efficacy and surgical outcome comparisons still lack primary trial data even after ASCRS Ch60 - Rectal Prolapse's mechanism-based treatment split; Rectocele separately now has recurrence-rate figures and a preference meta-analysis via ASCRS Ch59 - Treatment of Difficult-Obstructive Defecation (see the obstructed-defecation studies above), though still no independently-ingested primary source there either.
• [ ] Hereditary CRC syndromes — Lynch Syndrome, Familial Adenomatous Polyposis (FAP), Hamartomatous Polyposis Syndromes — genetic/chemoprevention trial data, extended vs. limited colectomy RCT data for Lynch.

Contested clinical questions worth a dedicated source

Genuinely active debates where the wiki currently describes both sides without comparative data.

• [ ] Stenting-as-bridge-to-surgery vs. straight-to-surgery for obstructing colon cancer — flagged independently on both Large Bowel Obstruction and Obstructing Colon Cancer.
• [ ] Antibiotics vs. no antibiotics for uncomplicated diverticulitis — see Diverticulitis.
• [ ] taTME long-term oncologic outcomes vs. conventional TME — see Total Mesorectal Excision (TME) & Sphincter-Sparing Resection.

Maintenance

• This list isn't exhaustive — it's a sweep of explicit "Open items / gaps" notes, not a literature search. Smaller, page-specific gaps (e.g. LARS score validation, CME with central vascular ligation, malrotation/volvulus) remain on their respective pages' own Open items sections and aren't duplicated here.
• When a listed study is ingested, check it off here, link the new source page, and update the originating page's Open items note so the two don't drift out of sync.