Canadian Journal of Surgery最新文献

{"title":"Improving access to surgical care for Inuit communities in Nunavik: a cost-savings analysis of a surgeon outreach program.","authors":"Sarah Mashal, Natasha G Caminsky, Jonathon R Campbell, Natalie Boulanger, Larry Watt, Jeremy R Grushka, Paola Fata, Dan L Deckelbaum, Kosar Khwaja, Katherine McKendy, Atif Jastaniah, Evan Wong","doi":"10.1503/cjs.013525","DOIUrl":"https://doi.org/10.1503/cjs.013525","url":null,"abstract":"<p><strong>Background: </strong>Access to timely surgical care in remote regions remains a substantial challenge. We sought to evaluate the societal costs of 2 models for delivering general surgery consultations to Nunavimmiut patients, namely an outreach model involving specialist travel to the Inuulitsivik Health Centre in Puvirnituq, and the traditional model requiring patient transfer to urban tertiary care in Montréal.</p><p><strong>Methods: </strong>We conducted a cost analysis for all general surgery consultations from May 30, 2022, to May 24, 2024, corresponding to the first 2 years of the specialist travel program. We estimated costs across 4 representative 1-week travel periods. Direct costs included surgeon remuneration, travel, and local service expenses. Indirect costs accounted for lost wages based on the median Nunavik income. Assumptions on travel duration, accommodations, and interpreter services were based on provincial data and Ullivik historical records.</p><p><strong>Results: </strong>The specialist travel model was consistently less costly across all periods analyzed. Patients seen in Puvirnituq incurred lower direct and indirect costs than those transferred to Montréal. The annual cost for urban-based care was $1.86 million compared with $163 000, leading to potential cost savings of $1.7 million annually or $12 000 per consultation. Sensitivity analyses confirmed cost advantages under a broad range of assumptions.</p><p><strong>Conclusion: </strong>Deploying specialists to Puvirnituq for surgical consultations is a cost-effective alternative to patient displacement. This model holds promise for improving equitable access to care in remote communities while reducing the financial burden on health care systems.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 3","pages":"E221-E229"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovation and Entrepreneurship in Surgical Training (INVEST): the first Canadian curriculum for innovation and entrepreneurship for surgical trainees.","authors":"Tyler McKechnie, Christopher D Griffiths, Ikennah Browne, Olivia Kuszaj, Naomi Downer, Alex Thabane, Philip Staibano, Brad Petrisor, John Kelton, Mohit Bhandari","doi":"10.1503/cjs.015624","DOIUrl":"https://doi.org/10.1503/cjs.015624","url":null,"abstract":"<p><strong>Background: </strong>The Innovation and Entrepreneurship in Surgical Training (INVEST) curriculum was developed to introduce surgical residents to basic concepts of innovation and entrepreneurship. The INVEST curriculum involves a series of 4 academic sessions teaching pillars of surgical innovation and entrepreneurship: identifying needs, value assessment, exploring feasibility, and telling a story. We prospectively examined participant perceptions before and after the INVEST curriculum.</p><p><strong>Methods: </strong>This longitudinal survey study included consecutive surgical trainees in their first year of training across 9 surgical specialties who partook in the INVEST curriculum at McMaster University. The primary outcome was change in perceived ability to succeed in achieving meaningful contributions to surgical innovation. Change in willingness to complete future training in surgical innovation was a secondary outcome. We used McNemar tests and Wilcoxon matched-pairs signed-rank tests to analyze differences in pre- and postcourse data.</p><p><strong>Results: </strong>Forty-seven residents attended the INVEST sessions and 36 completed both the pre- and post-INVEST surveys (76.6%). The mean age of respondents was 27.0 years and 53.2% were female. Resident confidence in health care innovation and entrepreneurship knowledge improved 2.2-fold (14.9% to 33.3%, <i>p</i> < 0.01) following completion of the INVEST curriculum. The curriculum sparked interest in further education among 17% of participants, while reducing interest in 14%.</p><p><strong>Conclusion: </strong>Participants' self-perceived ability to partake in entrepreneurial exploits increased following completion of the INVEST curriculum. Similar to training curricula in research, entrepreneurship education sparked interest in some, while decreasing interest in others. Early exposure to entrepreneurship in surgical training may help residents identify opportunities for investment of time.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 3","pages":"E211-E220"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver transplantation from donors following medical assistance in dying: a scoping review and retrospective cohort study.","authors":"Olivia Ganescu, Magan Solomon, Prosanto Chaudhury, Steven Paraskevas, Lindsay Hales, Myriam Martel, Peter Metrakos, George Zogopoulos, Jean Tchervenkov, Philip Wong, Alan Barkun, Jeffrey Barkun","doi":"10.1503/cjs.017825","DOIUrl":"https://doi.org/10.1503/cjs.017825","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation from donors following medical assistance in dying (MAiD) is a novel practice with emerging Canadian outcomes data. We sought to compare donor and recipient outcomes after liver transplantation following donor MAiD, circulatory death (DCD), or brain death (DBD).</p><p><strong>Methods: </strong>We conducted a scoping review and a single-centre retrospective cohort study.</p><p><strong>Results: </strong>The 5 retrospective studies identified found comparable short-term liver graft and patient survival between MAiD, DCD, and DBD liver recipients, with no differences in vascular complications or primary nonfunction. One study noted higher biliary complications among MAiD liver recipients. Our single-centre retrospective cohort reporting included 177 liver transplant recipients between 2018 and 2024 (19 MAiD, 14 DCD, and 144 DBD donors). Among donors, MAiD (mean age 59 yr) and DBD (mean age 57 yr) donors were older than DCD donors (mean age 37 yr; <i>p</i> < 0.001) and had lower median body mass index than other donors (MAiD 20, DCD 22, DBD 26; <i>p</i> < 0.001). Cold ischemia times were longest for DBD grafts (6.6 h v. 6.2 h DCD and 5.8 h MAiD; <i>p</i> = 0.02), with no other intraoperative differences. Rates of mortality within 90 days (<i>p</i> = 0.7), complications (Clavien-Dindo grade ≥ 3; <i>p</i> = 0.4), and retransplant (<i>p</i> = 0.6) were comparable across groups. Biliary strictures affected 42% MAiD, 35% DCD, and 13% DBD livers (<i>p</i> = 0.005), mostly extrahepatic and anastomotic strictures. Kaplan-Meier analysis found no significant difference in graft survival between donor groups (<i>p</i> = 0.7), Cox regression identified portal vein thrombosis (hazard ratio [HR] 23.98, 95% confidence interval [CI] 2.41 to 238.15), hepatic artery thrombosis (HR 8.14, 95% CI 1.72 to 38.54), and biliary complications (HR 11.93; 95% CI 2.31 to 61.76) as independent predictors of graft loss.</p><p><strong>Conclusion: </strong>Liver transplantation from donors who underwent MAiD was not associated with higher graft loss or mortality than in those who underwent DCD or DBD. Its continued use is safe, and larger multicentre studies are warranted for validation.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 3","pages":"E230-E242"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution and contributions of the <i>Canadian Journal of Surgery</i>: a bibliometric study.","authors":"Meghan Boersma Robertson, Jacob J Wiseman, Arel Steen, Rachel S Leong, Sam M Wiseman","doi":"10.1503/cjs.003226","DOIUrl":"https://doi.org/10.1503/cjs.003226","url":null,"abstract":"<p><strong>Background: </strong>We sought to perform a bibliometric analysis of all papers published in the <i>Canadian Journal of Surgery</i> (<i>CJS</i>) since its indexing in 1968 to identify meaningful contributions and trends in publication, and thus an overview of its influence in the field.</p><p><strong>Methods: </strong>Bibliometric data from all articles published in <i>CJS</i> between Jan. 1, 1968, and Dec. 31, 2024, were extracted from the Web of Science Core Collection database. Descriptive and visual bibliometric analysis were performed using Bibliometrix and VOSViewer software, respectively.</p><p><strong>Results: </strong>Excluding meeting abstracts, 6524 articles were published in <i>CJS</i> during the 57-year study period. The average age of these items was 28 years, with an average citation rate per item of 9.61 and an annual growth rate of 0.69%. Most of these items were original studies (<i>n</i> = 4594 [70.4%]) from Canadian centres (<i>n</i> = 3207 [49.2%]). Twenty-nine classic-cited papers were identified. Bibliometric analysis helps to identify trends in research and sharpen the focus of the readership of <i>CJS</i> by highlighting what makes specific articles more citable and important in advancing the literature. The characteristics of the most cited papers include novelty, generalizability across surgical disciplines, and genuine applicability to surgical practice.</p><p><strong>Conclusion: </strong>The most productive countries, provinces, institutions, authors, and topics were identified. <i>CJS</i> remains an important part of Canadian surgical discourse through its continued dissemination of quality research across Canada and beyond.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 2","pages":"E176-E187"},"PeriodicalIF":2.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where have we been and where are we going? Contributions of the <i>Canadian Journal of Surgery</i> to the greater surgical community.","authors":"Chad G Ball, Edward J Harvey","doi":"10.1503/cjs.007726","DOIUrl":"https://doi.org/10.1503/cjs.007726","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 2","pages":"E173"},"PeriodicalIF":2.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"État de la situation et perspectives d’avenir — Contributions du <i>Journal canadien de chirurgie</i> à l’ensemble de la communauté chirurgicale.","authors":"Chad G Ball, Edward J Harvey","doi":"10.1503/cjs.008226","DOIUrl":"https://doi.org/10.1503/cjs.008226","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 2","pages":"E174-E175"},"PeriodicalIF":2.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core competencies for global surgery training: a scoping review.","authors":"Roy A Hilzenrat, Rachel J Livergant, Catherine J Binda, Jayd Adams, Allison Chhor, Adrianna Paiero-Keeler, Jo-Anne Petropoulos, Helen Hsiao, Faizal Haji, Esther Anne Chin","doi":"10.1503/cjs.014525","DOIUrl":"https://doi.org/10.1503/cjs.014525","url":null,"abstract":"<p><strong>Background: </strong>Despite calls from various global organizations for increased attention to global surgery, guidance on developing effective curricula is lacking. In this scoping review, we aimed to outline the necessary learning objectives and competencies for establishing sustainable, equitable, and noncolonialist academic global surgery programs.</p><p><strong>Methods: </strong>This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews. We used key terms to search 5 electronic databases and conducted a comprehensive grey literature search to identify universities, medical programs, and organizations offering academic global surgery programs. We categorized curricular objectives extracted from these sources into the 11 domains of global health defined by the Consortium of Universities on Global Health. We employed thematic analysis to further categorize these objectives into unique themes within each domain.</p><p><strong>Results: </strong>We found a total of 43 studies and 61 programs through database and grey literature searches, respectively. These sources yielded 333 unique curricular objectives, which we analyzed thematically, revealing 41 unique themes spanning various neglected areas in global surgery, such as Indigenous health, environments, chronic diseases, technology, and underserved populations like refugees, urban populations of low socioeconomic status, and racial and ethnic minority groups.</p><p><strong>Conclusion: </strong>This review outlines essential skills for effective engagement in modern global surgical care, emphasizing the emergence of nontraditional themes like bidirectional partnerships, sustainability, and self-governance over mission-based approaches. Integrating these forward-looking themes into global surgery curricula is vital for improving global surgical care standards and fostering a skilled, globally aware workforce.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 2","pages":"E188-E199"},"PeriodicalIF":2.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent postoperative opioid use in patients treated with total hip arthroplasty and hemiarthroplasty for femoral neck fracture: a propensity-score-matched analysis.","authors":"Mina Tohidi, Jensen Murphy, Stephen M Mann, Patti A Groome","doi":"10.1503/cjs.020425","DOIUrl":"https://doi.org/10.1503/cjs.020425","url":null,"abstract":"<p><strong>Background: </strong>Pain management after hip fracture surgery is particularly challenging because clinicians must simultaneously minimize prolonged opioid exposure while ensuring effective recovery in this vulnerable patient population. We sought to compare persistent postoperative opioid use across a matched group of patients with femoral neck fracture treated with either total hip arthroplasty (THA) or hemiarthroplasty and to describe the association between patient characteristics and opioid use.</p><p><strong>Methods: </strong>Routinely collected health care databases were linked at ICES to create a population-based cohort of patients aged 66 years or older in Ontario, Canada, who underwent THA or hemiarthroplasty for a femoral neck fracture between 2002 and 2016. We used propensity-score matching to balance potential confounders. We quantified and compared persistent postoperative opioid use between treatment groups using survival analysis.</p><p><strong>Results: </strong>The full cohort consisted of 45 119 patients, of whom 41 247 (91.4%) were treated with hemiarthroplasty and 3872 (8.6%) were treated with THA. More than half (<i>n</i> = 25 168, 55.8%) of patients had not filled an opioid prescription in the year before hip fracture and were considered naive to opioids. Overall, 5958 (23.7%) opioid-naive patients filled at least 1 opioid prescription between 90 days and 1 year after hip fracture. All eligible patients who underwent THA were matched 1:2 to hemiarthroplasty patients (matched cohort <i>n</i> = 6492). There was no statistically significant difference in persistent postoperative opioid use between treatment groups (relative risk 1.06, 95% confidence interval 0.96 to 1.17). Patients living in long-term care or requiring home care services and patients with a high comorbidity burden were more likely to use opioid medication, before and after hip fracture.</p><p><strong>Conclusion: </strong>Persistent opioid use is common after both THA and hemiarthroplasty for hip fracture. Patients with higher health care needs before fracture and higher comorbidity burden were more likely to persistently use postoperative opioids.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 2","pages":"E200-E210"},"PeriodicalIF":2.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the scalpel: redefining surgical training for tomorrow: Canadian Conference for the Advancement of Surgical Education, Oct. 16-17, 2025 Winnipeg, Manitoba.","authors":"Franciska Otaner, Abrar Ahmed, Zeel Patel, Farbod Niazi, Saman Arfaie, Ashish Kumar, Norbert Banyi, Dianne Valenzuela, M Elise Graham, Amanda C Hu, Meerab Majeed, Aljeena Rahat Qureshi, Armaan K Malhotra, Negeen Halabian, Vidhi Bhatt, Ajibola Anifowose, Armaghan Alam, David-Dan Nguyen, Betel Yibrehu, Kennedy Ayoo, Adom Bondzi-Simpson, Savtaj Brar, Adom Bondzi-Simpson, Betel Yibrehu, Vatineh Magaji, Kianna Brown, Armaan K Malhotra, David-Dan Nguyen, Kennedy Ayoo, Biniam Kidane, Shiva Jayaraman, Brent Zobolotny, Sean P Cleary, Savtaj Brar, Breanna Chen, Éolie Delisle, Jessica Forcillo, Frédérique Leroux, Félix Girolamo-Cousineau, Yasmin Osman, Léamarie Meloche-Dumas, Merieme Habti, Florence Bénard, Patrick Lavoie, Adam Dubrowski, Rami Younan, Kerianne Boulva, Ahmad Kaviani, Érica Patocskai, Fariha Rahman, Sonika Khurana, Skanda Kaushik, Yousef Darwish, Ali Bayrouti, Emma Forrester, Farah Ali, Kaileb Olson, Rayyan Zuberi, Zach Oleynik, Mars Zhao, David Sauder, Noor Al Kaabi, Aljeena Qureshi, Abdollah Behzadi, Afreen Ahmad, Aljeena Qureshi, Kevin Ly, Kyobin Hwang, Radha Kohly, Micheal Nguyen, Carla Starvaggi, Maryse Bouchard, Mark Kristina Keitel, Kai Ziebarth, Sasha Carsen, Alexandra Mortimer, Ryan Katchky, Anthony Cooper, Ron El-Hawary, Lori-Ann Archer, Neil Saran, Jennifer Stimec, Martin Pusic, Kathy Boutis, Jammie Lee, Kyle Gallant, Ashley Vergis, Krista Hardy, Wenjing He, Aljeena Rahat Qureshi, Waleed K S Alsarhani, Alexander J Kaplan, Norbert Banyi, Arman Abdalkhani, Yun Wu, Bin Zheng, Yun Wu, Bin Zheng, Huan Yu Lily Dai, Pamela Brazeau-Porrello, Merieme Habti, Asma Abdullah, Johnny Efanov, Peter Alam, Lijun Song, Adam Dubrowski, Erica Patocskai, Akanksha Guleria, Alex Thabane, Moad Alsefaou, Phillip Staibano, Tyler McKechnie, Ashlyn Chou, Goran Calic, Mohit Bhandari, Yuzhang Li, Xinming Li, Bin Zheng, Emma Forrester, Mike Paget, Anabel Bergeron, Hong Hao Xu, Laurent Tessier, Philippe Lacroix, Stéphane Jacques, Maude Bouchard, Tetyana Tzomko, Josée Tessier, Lucas Sideris, Marianne Gagnon-Konamna, Patricia Egerszegi, Taylor Marshall, Cameron Elgie, Roy Kirkpatrick, Lisa Allen, Magdalena Partyka-Sitnik, Gabriel Berberi, Denia Hamidi, Ojasvi Sharma, Elie Fadel, Jack Legler, Emily Steinberg, Gregory Mikerov, Ipinu Fatokun, Hasnaien Ahmed, Abdollah Behzadi, Sayf Gazala, Mehdi Qiabi, Jonathan White, Simon Turner, Thomas Manuel, Odile Huynh, Morgan Wokes, Suyin A Lum Min, B J Hancock, Giuseppe Retrosi, Emma Forester, Fariha Rahman, Mohammad Omer, Grace Perez, Caitlin McClurg, Aaron Johnston, Adrian Harvey, Ali Bayrouti, Austin A Barr, Farah Ali, Adam Guthrie, Nawab Azizi, Denesh Peramakumar, Peter Szasz, Sarah Jones, Boris Zevin, Dhruv Patel, Jonathan Babulic, Andrea Winthrop, Steve Mann, Laura Sims, Krista Trinder, Dave Gwun, Victoria Tucci, Alexandra D'Souza, Thomas Milazzo, Sophocles Voineskos, David Wallace, Kyle Wanzel, Shaishav Datta, Imen Benadda, Noa Bouzaglo, Andrew Gorgy, Shannon Fraser, Helia Dana Mansouri, Samuel Tholl, Alexander Moise, Andrew Thamboo, Anjali Jagannathan, Krystina Clarke, Rahima Mazlomyar, Lisa Satterthwaite, Otto Sanchez, Adam Dubrowski, Ruxandra Penta, Robert Harutyunyan, Wenjing He, Ashley Vergis, Krista Hardy, Chirag Chopra, Souzan Yacob, Bonnie Yang, Nicholas Laflamme, Eleftheria Laios, Wiley Chung, Charlotte McEwen, Rachel Beetham, Iqbal Jaffer, Elif Bilgic, Matthew Sibbald, Zena Martineau-Karakach, Éolie Delisle, Lisa Hannane, Mathieu Bergeron, Imen Benadda, Laury Gueyie, Masayuki Fukumoto, Junko Tokuno, Gerald M Fried, Christa Aubrey, Matthew Robrigado, Nicole Green, Kaylie Welykholowa","doi":"10.1503/cjs.006726","DOIUrl":"10.1503/cjs.006726","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 2suppl1","pages":"S1-S15"},"PeriodicalIF":2.2,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The growing burden of spine surgical wait times: a retrospective cohort study of longitudinal trends and impact on perioperative outcomes.","authors":"Jessica C W Wang, John Street, Tamir Ailon, Michael Bond, Raphaële Charest-Morin, Nicolas Dea, Marcel Dvorak, Charles Fisher, Brian K Kwon, Scott Paquette, Charlotte Dandurand","doi":"10.1503/cjs.000625","DOIUrl":"10.1503/cjs.000625","url":null,"abstract":"<p><strong>Background: </strong>Surgical delays are common in public health care systems such as Canada's. Trends in wait times for elective spine surgery and their impact on outcomes remain uncharacterized.</p><p><strong>Methods: </strong>We performed a single-centre analysis of elective spine surgery data between 2009 and 2020. We assessed wait times between referral and initial consultation (T1), consultation and surgical booking (interval wait time; Ti), and booking and surgery (T2) in terms of trends and impact on perioperative outcomes (adverse events and hospital length of stay [LOS]).</p><p><strong>Results: </strong>In total, 2041 patients were included. Over the study period, total wait time (T1+Ti+T2) increased 5.6% annually (<i>p</i> < 0.001). Specifically, T1 decreased 4.8% (<i>p</i> < 0.001), Ti increased 14.9% (<i>p</i> < 0.001), and T2 increased 8.5% (<i>p</i> < 0.001) from year to year. The cumulative increase in total wait time was 72.4%, and the cumulative increase in Ti was 301.1% over the 10-year period. Longer total wait time and Ti were associated with increased rate of adverse events (<i>p</i> < 0.001 and <i>p</i> < 0.001, respectively) and odds of adverse events (<i>p</i> < 0.001 and <i>p</i> < 0.001, respectively). Delays in all wait time intervals were associated with longer LOS (<i>p</i> < 0.001), with T2 having the largest effect of a 10.8% increase in LOS per 100 days of T2 (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Total wait times (T1+Ti+T2) for elective spine surgery significantly increased between 2009 and 2020. Ti showed the largest increase over the study period and was associated with a significant increase in adverse events. Future studies should investigate the impact of various efforts implemented and whether this translates to improved surgical outcomes and resource management.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 2","pages":"E164-E172"},"PeriodicalIF":2.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}