Canadian Journal of Surgery最新文献

{"title":"Les soins chirurgicaux au Canada et le coût de l’inaction.","authors":"Edward J Harvey, Chad G Ball","doi":"10.1503/cjs.012226","DOIUrl":"10.1503/cjs.012226","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 3","pages":"E275-E276"},"PeriodicalIF":2.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162028","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":"Surgical care in Canada and the cost of inaction.","authors":"Edward J Harvey, Chad G Ball","doi":"10.1503/cjs.011526","DOIUrl":"10.1503/cjs.011526","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 3","pages":"E270-E271"},"PeriodicalIF":2.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162015","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":"Improving operating room efficiency for primary joint replacements in a medium-sized rural community hospital using positive deviance seminars.","authors":"Nicholas Nucci, Koorosh Kashanian, Matey Juric, Ariane Parisien, Simon Garceau, Andrew Seely, Stéphane Poitras, Paul E Beaulé","doi":"10.1503/cjs.012425","DOIUrl":"10.1503/cjs.012425","url":null,"abstract":"<p><strong>Background: </strong>Improving operating room (OR) throughput is a constant challenge. Given evidence that positive deviance (PD) sessions to identify excelling individuals and disseminate their strategies lead to improvements in a tertiary care institution, we sought to use PD sessions to increase the success in completing 4 joint arthroplasties in a day in a rural hospital.</p><p><strong>Methods: </strong>We conducted PD sessions for 13 OR nurses, 4 family physician anesthetists or anesthesiologists, and 2 orthopedic surgeons. Best-performing staff shared strategies. We measured efficiency and agreement, which were then discussed at future PD sessions. Our primary outcome was success in completing 4 joint arthroplasties in a day. We recorded time from the patient being in the OR to anesthesia-ready (anesthesia prep time), time from the patient being anesthesia-ready to surgery start (surgery prep time), procedure length, time from surgery finish to the patient leaving the room (anesthesia finish time), and room turnover time. We collected data before PD sessions (baseline), 1 to 5 months post-PD sessions (short-term follow-up), and 9 to 13 months post-PD sessions (long-term follow-up).</p><p><strong>Results: </strong>Before PD sessions, 48.7% of joint arthroplasty days were completed on time. At short- and long-term follow-up, 87.5% and 80.0% were completed on time. The average time to complete 4 cases decreased. Notable changes were made in anesthesia prep time (21 min at baseline, 17 min at both short- and long-term follow-up), and turnover time (30 min at baseline, 25 min at short-term follow-up, 23 min at long-term follow-up).</p><p><strong>Conclusion: </strong>Overall, PD sessions in a rural hospital increased success in completing 4 joint arthroplasties in a day with minimal costs, stimulating local strategies for efficiency. Long-term sustainability and applicability to other surgical procedures or specialties is yet to be determined.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 3","pages":"E251-E257"},"PeriodicalIF":2.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926689","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":"Quality assessment of videos on anterior cruciate ligament tear rehabilitation exercises: Is TikTok a good source of medical information for patients?","authors":"Xavier Sonesaksith-Turcotte, Cariane Driad, Marie-Lyne Nault","doi":"10.1503/cjs.006625","DOIUrl":"10.1503/cjs.006625","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) tear is a common injury, and accurate and inaccurate medical information is readily accessible on social media platforms. We sought to assess the quality of rehabilitation exercise videos available on TikTok regarding ACL tears.</p><p><strong>Methods: </strong>We used the keywords \"ACL rehab exercises\" to search the TikTok database, and we reviewed the first 113 videos. We retrieved information such as the number of views and likes for statistical analysis. We considered 2 types of users: general users and health care professionals. We included videos with a subject about a rehabilitation exercise for ACL tears and in the English language. We excluded videos that were duplicates and that followed a TikTok trend. Two raters assessed the quality of videos with the Modified DISCERN (mDISCERN) instrument and the ACL Exercise Education Score (AEES). A third author resolved any disagreement. We calculated descriptive statistics and used the Mann-Whitney test for nonparametric samples to compare the quality of content between groups.</p><p><strong>Results: </strong>We included 106 TikTok videos in the analysis. Fifty-five videos were created by general users and 51 videos by health care professionals. Videos by general users had significantly more likes (57 700 v. 788, <i>p</i> = 0.02). The overall quality of videos was poor, according to the mDISCERN instrument (score 1.99 ± 1.18), although health care professionals had significantly better-quality videos (score 3.10 ± 0.04) than general users (score 0.96 ± 0.09) (<i>p</i> < 0.001). Significance was similar with the mean AEES (score 7.62 v. 4.85, <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>Although health care professionals produced better-quality videos than general users, they were not the main producers of content in this study. Moreover, the overall quality and reliability of all the videos included in this study was poor. We encourage health care professionals to create a greater number of videos that contain quality information and that fit the TikTok format.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 3","pages":"E243-E250"},"PeriodicalIF":2.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926436","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":"Understanding the long-lasting impact of the COVID-19 pandemic on the diagnosis and management of lung cancer: a retrospective community hospital experience.","authors":"Gursharan Sohi, Aarya Gore, Najib Safieddine, Sayf Gazala, Carmine Simone, Negar Ahmadi","doi":"10.1503/cjs.015925","DOIUrl":"10.1503/cjs.015925","url":null,"abstract":"<p><strong>Background: </strong>Cancer care was negatively affected during the COVID-19 pandemic. We sought to examine the long-term effects of the COVID-19 pandemic on patterns of lung cancer care among patients undergoing surgical resection at our thoracic surgery program.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all patients who underwent lung resection for cancer at Michael Garron Hospital between 2018 and 2024. We categorized patients into 3 cohorts: prepandemic (2018 to 2019), COVID-19 pandemic (2020 to 2022), and postpandemic (2023 to 2024). We analyzed demographic characteristics, time to surgery, length of stay, multimodal treatment, and pathological stage.</p><p><strong>Results: </strong>We included 1090 patients. The time from consent to surgery was shorter in the pandemic cohort (26 v. 29 d; <i>p</i> < 0.01). Length of stay was also shorter during the pandemic and postpandemic periods (median 2 v. 3 d; <i>p</i> < 0.001). A higher proportion of patients presented with advanced-stage lung cancer (stage III) in the prepandemic cohort than in the other cohorts (15% v. 9%, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>We found no significant delays in surgical care for lung cancer during the COVID-19 pandemic. Timelines to surgery may have been expedited owing to increased resource allocation. Through further study of adaptive mechanisms used during the pandemic, we can continue to provide increasingly effective and efficient lung cancer care.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 3","pages":"E258-E263"},"PeriodicalIF":2.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147926401","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":"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":"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":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155878/pdf/","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":"OA","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":"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":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155882/pdf/","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":"OA","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":"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":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155884/pdf/","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":"OA","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":"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":2.0,"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":"10.1503/cjs.007726","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"69 2","pages":"E173"},"PeriodicalIF":2.0,"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}