Canadian Journal of Surgery最新文献

{"title":"Analyzing the temporal trends of kidney transplantation surgeries and their impact on warm and cold ischemia time in a Canadian setting.","authors":"Ali Dergham, Luke Witherspoon, Joseph Y Nashed, Thomas Skinner, Liam Power, John Mahoney, Brian Blew, Jeffrey T Warren","doi":"10.1503/cjs.013422","DOIUrl":"10.1503/cjs.013422","url":null,"abstract":"<p><strong>Background: </strong>The effect of weekend admission and surgery on patient morbidity and mortality has been studied in many settings and has been shown to lead to worse outcomes. Several studies have sought to determine whether there is a weekend effect in kidney transplantation specifically, but a clear effect on outcomes and graft survival has not been established.</p><p><strong>Methods: </strong>We analyzed data from all deceased-donor organ procurements and cadaveric kidney transplants occurring during the 5-year period between Apr. 1, 2013, and Dec. 31, 2017, included in the database of the Trillium Gift of Life Network, Ontario's organ and tissue donation agency.</p><p><strong>Results: </strong>A total of 1116 deceased donor nephrectomies (DNs) and 1858 recipient procedures were performed in Ontario during the study period. The overall rate of after-hours DNs on weekdays was significantly greater than during working hours (23.1/30 d v. 15.4/30 d, <i>p</i> < 0.001). Donations after neurological determination of death were more frequent during weekday working hours (22.8/30 d) than after hours on weekdays (17.3/30 d, <i>p</i> < 0.001) or weekends (16.3/30 d, <i>p</i> < 0.001), whereas donations after cardiac death were significantly more frequent after hours on weekdays than during working hours (10.3/30 d v. 7.7/30 d, <i>p</i> = 0.021). On weekdays, mean warm ischemia time (WIT) was significantly longer after hours than during working hours (40.75 ± 12.26 min v. 38.52 ± 11.92 min, <i>p</i> = 0.017). Similarly, mean WIT was longer after hours than during working hours on weekends (40.23 ± 12.48 min v. 38.59 ± 11.91 min, <i>p</i> = 0.015).</p><p><strong>Conclusion: </strong>Kidney transplantations occurred more frequently after hours and were associated with increased WIT. Further study is needed across multiple Canadian centres to better understand the temporal patterns of kidney transplantation and implications for patients, providers, and health care systems.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6","pages":"E406-E415"},"PeriodicalIF":2.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852950","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":"La contribution des militaires au paysage chirurgical canadien.","authors":"Chad G Ball, Edward J Harvey","doi":"10.1503/cjs.015224","DOIUrl":"10.1503/cjs.015224","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6","pages":"E419"},"PeriodicalIF":2.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853006","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":"Correction to: \"Incidence and timing of postoperative complications after total hip and knee arthroplasty\".","authors":"","doi":"10.1503/cjs.015324","DOIUrl":"10.1503/cjs.015324","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6","pages":"E420"},"PeriodicalIF":2.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000631","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":"Does the type of biomesh influence recurrence in abdominal wall reconstruction? A long-term follow-up to a randomized controlled trial.","authors":"Jaiden Punia, Chad G Ball, Andrew W Kirkpatrick, Thomas Clements","doi":"10.1503/cjs.011624","DOIUrl":"10.1503/cjs.011624","url":null,"abstract":"<p><p>SummaryThis discussion describes the long-term follow-up of a prospective randomized controlled trial evaluating the performance of the 2 most common biomesh products utilized in the context of complex abdominal wall reconstructions. Although the incidence of hernia recurrence increased over time to 26% (median follow-up 62 mo), both biomesh products performed similarly. Biomesh product choice should remain cost-conscious.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6","pages":"E416-E417"},"PeriodicalIF":2.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853002","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":"Military contributions to our Canadian surgical landscape.","authors":"Chad G Ball, Edward J Harvey","doi":"10.1503/cjs.015024","DOIUrl":"10.1503/cjs.015024","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6","pages":"E418"},"PeriodicalIF":2.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853036","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":"Referral patterns for common surgical procedures in Ontario: a cross-sectional population-level study.","authors":"Pardis Seyedi, Dionne Aleman, Nancy Baxter, Chaim Bell, Merve Bodur, Andrew Calzavara, Robert Campbell, Michael Carter, Pieter de Jager, Scott Emerson, Anna Gagliardi, Jonathan Irish, Danielle Martin, Samantha Lee, Marcy Saxe-Braithwaite, Julie Takata, Suting Yang, Claudia Zanchetta, David Urbach","doi":"10.1503/cjs.002324","DOIUrl":"10.1503/cjs.002324","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the existing structure and function of referral networks in the prevalent referral system for specialized surgical care in Canada, which is based on direct physician referral to specialists in a largely unmanaged referral marketplace. Our objective was to describe and analyze the referral networks of referring physicians and surgeons for common surgical procedures in Ontario, to better understand potential barriers to single-entry models.</p><p><strong>Methods: </strong>We analyzed referral networks for patients between referring physicians and surgeons for 9 common scheduled surgical procedures from 2016 to 2019 using administrative data sources in Ontario. We described the connectedness of referring physician-surgeon pairs using descriptive measures and graphical social network analysis.</p><p><strong>Results: </strong>The median number of surgeons connected to a referring physician for patients having a particular surgical procedure ranged from 1 (interquartile range [IQR] 1-3) for spine surgery to 3 (IQR 1-4) for knee arthroplasty and 3 (IQR 2-5) for noncancer uterine procedures. Referral network structure varied according to the procedure studied. Spine surgery was highly clustered with a small number of larger groups; gallbladder, inguinal hernia, and noncancer uterine surgery were highly distributed with many small groups within the referral network. Breast cancer surgery occurred in a largely distributed network, but with a skewed distribution reflecting a few small groups with large numbers of patients.</p><p><strong>Conclusion: </strong>Improving surgical wait times by coordinating surgical referrals will require approaches that address the structure of existing referral networks. Most physicians refer their patients to a very small number of surgeons, suggesting that referring physicians largely do not individualize referrals to multiple different surgeons based on specific patient characteristics.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6","pages":"E397-E405"},"PeriodicalIF":2.2,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821944","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":"Complications of cerebrospinal fluid drainage in thoracoabdominal aortic procedures.","authors":"Halli Krzyzaniak, Martina Vergouwen, Darren Van Essen, Curtis Nixon, R Scott McClure, Nadeem Jadavji, Randy D Moore, Kenton Rommens","doi":"10.1503/cjs.003624","DOIUrl":"10.1503/cjs.003624","url":null,"abstract":"<p><strong>Background: </strong>Cerebrospinal fluid (CSF) drainage is used to reduce spinal cord ischemia (SCI) in patients undergoing thoracoabdominal aortic procedures. Recent literature has found high rates of complication associated with CSF drainage, which has led to changes in practice. The aim of this study was to investigate rates of CSF drain-related complications in patients undergoing a thoracoabdominal aortic procedure with perioperative placement of a CSF drain.</p><p><strong>Methods: </strong>We conducted a single-centre retrospective cohort study. We defined major complications as intracranial hemorrhage, epidural hematoma or abscess, meningitis, and catheter retention requiring a reoperation. Minor complications assessed included drain-induced neurologic deficits, CSF leak, postdural puncture headache, asymptomatic blood in the CSF, drain failure, and catheter retention not requiring a reoperation. We recorded postoperative neurologic deficits as secondary outcomes.</p><p><strong>Results: </strong>There were 129 patients who met the inclusion criteria. We found 5 cases of permanent paraplegia in the overall cohort (3.9%), with only 2 occurring in the patients with prophylactic CSF drains (1.6%). There were no major CSF drain-related complications. The rate of minor complications was 17.8%. We found no association between complication rates and indication for procedure or type of operation.</p><p><strong>Conclusion: </strong>The lack of major complications in this series adds to existing variability in recent literature and provides support for continued use of this adjunct for SCI prevention. Further research is required to identify the etiology of significant differences in CSF drain complication rates seen at other centres.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6","pages":"E389-E396"},"PeriodicalIF":2.2,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821943","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":"2024 Canadian Surgery Forum: Sept. 25-28, 2024.","authors":"Christine Li, Michael Guo, Ahmer Karimuddin, Michael Guo, Christine Li, Ahmer Karimuddin, Jason Sutherland, Bright Huo, Tyler McKechnie, Monica Ortenzi, Yung Lee, Stavros Antoniou, Julio Mayol, Hassaan Ahmed, Vanessa Boudreau, Karim Ramji, Cagla Eskicioglu, Pieter de Jager, David Urbach, Meredith Poole, Aghiles Abbad, Hussain Al-Shamali, Zainab Al-Faraj, Chuck Wen, Radu Pescarus, Robert Bechara, Dennis Hong, Lily J Park, Maura Marcucci, Sandra Ofori, Jessica Bogach, Pablo E Serrano, Marko Simunovic, Ilun Yang, Margherita Cadeddu, Michael J Marcaccio, Flavia K Borges, Rahima Nenshi, P J Devereaux, Peter Urbanellis, Joanne Douglas, Evan Nemeth, James Ellsmere, Richard Spence, Joshua Cunningham, Ryan Falk, Tom Skinner, Nicole Ebert, Lauren Galbraith, Mark Prins, Shahrzad Joharifard, Emilie Joos, Adele Orovec, Lynn Lethbridge, Richard Spence, Marius Hoogerboord, Heather Stuart, Anne-Marie Bergeron, Ilun Yang, Jessica Bogach, Laura Nguyen, Clare Reade, Lua Eiriksson, Michelle Morais, Gillian Hanley, Sarah Mah, Karanbir Brar, Keri A Seymour, Shaina R Eckhouse, Ranjan Sudan, Jacob A Greenberg, Dana Portenier, James J Jung, Anne Light, Brittany Dingley, Megan Delisle, Sameer Apte, Ranjeeta Mallick, Trevor Hamilton, Heather Stuart, Martha Talbot, Gregory McKinnon, Evan Jost, Eve Thiboutot, Carolyn Nessim, Neha Katote, Ashley Drohan, Richard Spence, Katerina Neumann, Ge Shi, Regina Leung, Christina Lim, Matthew Van Oirschot, Aaron Grant, Sarah Knowles, Julie Ann Van Koughnett, Karine Brousseau, Leah Monette, Daniel McIsaac, Christopher Wherrett, Ranjeeta Mallick, Aklile Workneh, Tim Ramsay, Alan Tinmouth, Julie Shaw, François Martin Carrier, Dean Fergusson, Guillaume Martel, Matthew Cornacchia, Victoria Ivankovic, Shahad Abdulkhaleq Mamalchi, Dexter Choi, Peter Glen, Maher Matar, Fady Balaa, Natasha Caminsky, Sarah Mashal, Nathalie Boulanger, Larry Watt, Jonathon Campbell, Jeremy Grushka, Paola Fata, Evan Wong, Michael Guo, Ahmer Karimuddin, Jason Sutherland, Christine Li, Wenjie Lin, Ahmer Karimuddin, Bright Huo, Elisa Calabrese, Sunjay Kumar, Bethany Slater, Danielle S Walsh, Wesley Vosburg, Uzair Jogiat, Simon Turner, Vickie Baracos, Dean Eurich, Heather Filafilo, Eric Bedard, Sam Khan, Tom Waddell, Kazuhiro Yasufuku, Andrew Pierre, Shaf Keshavjee, Elliot Wakeam, Laura Donahoe, Marcelo Cypel, Najib Safieddine, Michael Ko, Natasha Leighl, Jamie Feng, Jonathan Yeung, Marc De Perrot, Alexandra Salvarrey, Negar Ahmadi, Carmine Simone, Gazala Sayf, David Parente, Victoria Cheung, Mary R Rabey, Michael Cabanero, Lisa W Le, Christodoulos Pipinikas, Amber Chevalier, Richard Chaulk, David Sahai, Richard Malthaner, Mehdi Qiabi, Dalilah Fortin, Richard Inculet, Rahul Nayak, John Campbell, Peter White, Adam Bograd, Alexander Farivar, Brian Louie, Geraint Berger, Daniel French, Simon Houston, Flyn Gallardo, Bryce Macek, Richard Liu, Biniam Kidane, Nader M Hanna, Yogita S Patel, Ikennah Browne, Esther Provost, Forough Farrokhyar, Ehsan Haider, Waël C Hanna, Garrett Johnson, George Okoli, Nicole Askin, Ahmed Abou-Setta, Harminder Singh, Alexandra Coxon-Meggy, Julie Cornish, Lars Icat Study Management Group, Sahil Sharma, Jigish Khamar, Jo-Anne Petropolous, Amandeep Ghuman, Wenjie Lin, Christine Li, Carl Brown, Terry Phang, Manoj Raval, Amandeep Ghuman, Elizabeth Clement, Ahmer Karimuddin, Tyler McKechnie, Jigish Khamar, Christopher Chu, Amin Hatamnejad, Ghazal Jessani, Yung Lee, Aristithes Doumouras, Dennis Hong, Cagla Eskicioglu, Giancarlo Sticca, Madeleine Poirier, Jean-François Tremblay, Jean-François Latulippe, Yves Bendavid, Jean-Sébastien Trépanier, Ariane Lacaille-Ranger, Margaret Henri, Tyler McKechnie, Tania Kazi, Victoria Shi, Shan Grewal, Ahmed Aldarraji, Kelly Brennan, Sunil Patel, Nalin Amin, Aristithes Doumouras, Sameer Parpia, Cagla Eskicioglu, Mohit Bhandari, Gaurav Talwar, Tyler McKechnie, Jigish Khamar, Luke Heimann, Swati Anant, Cagla Eskicioglu, Victoria Shi, Tyler McKechnie, Swati Anant, Moeiz Ahmed, Sahil Sharma, Gaurav Talwar, Dennis Hong, Cagla Eskicioglu, Tania Kazi, Tyler McKechnie, Yung Lee, Rehab Alsayari, Gaurav Talwar, Aristithes Doumouras, Dennis Hong, Cagla Eskicioglu, Lily J Park, Husein Moloo, Tim Ramsay, Kednapa Thavorn, Justin Presseau, Terry Zwiep, Guillaume Martel, P J Devereaux, Robert Talarico, Daniel I McIsaac, Madeline Lemke, Wenjie Lin, Carl Brown, Elizabeth Clement, Anu Ghuman, Terry Phang, Manoj Raval, Ahmer Karimuddin, Christine Li, Wenjie Lin, Elizabeth Clement, Amandeep Ghuman, Cameron Hague, Ahmer Karimuddin, P Terry Phang, Manoj Raval, Pari Tiwari, Patrick Vos, Carl Brown, Alessandro Ricci, Ameer Farooq, Sunil Patel, Kelly Brennan, Vanessa Wiseman, Tyler McKechnie, Allison Keeping, Paul Johnson, Heidi Bentley, Karim Messak, Jessica Bogach, Gregory Pond, Shawn Forbes, Vanja Grubac, Scott Tsai, Christian Van Der Pol, Marko Simunovic, Adom Bondzi-Simpson, Ramy Behman, Tiago Ribeiro, Sheron Perera, Aisha Lofters, Rinku Sutradhar, Rebecca Snyder, Callisia Clarke, Natalie Coburn, Julie Hallet, Natasha Caminsky, Alex Chen, Jeongyoon Moon, Paul Brassard, Daniel Marinescu, Teodora Dumitra, Ebram Salama, Carol-Ann Vasilevsky, Marylise Boutros, Kelly Brennan, Tyler McKechnie, Vanessa Wiseman, Alessandro Ricci, Ameer Farooq, Sunil Patel, Tania Kazi, Tyler McKechnie, Ghazal Jessani, Victoria Shi, Niv Sne, Aristithes Doumouras, Dennis Hong, Cagla Eskicioglu, Manisha Jogendran, Jennifer Flemming, Maya Djerboua, Martin Korzeniowski, Brooke Wilson, Shaila Merchant, Sean Bennett, Kala Hickey, Stephanie Gill, Zoë Breen, Kaitlyn Harding, Hannah Yaremko, Patti Power, Alex Mathieson, David Pace, Joannie Neveu, Sean Bennett, Brooke Wilson, Nan Chen, Weidong Kong, Sunil Patel, Christopher Booth, Shaila Merchant, Sean Bennett, Georgia Nelson, Nouf AlMarzooqi, Manisha Jogendran, Maya Djerboua, Brooke Wilson, Jennifer Flemming, Shaila Merchant, Lily J Park, Carol Wang, Vicki Archer, Tyler McKechnie, Dan Cohen, Jessica Bogach, Marko Simunovic, Pablo E Serrano, Rodney H Breau, Paul Karanicolas, P J Devereaux, Georgia Nelson, Nouf AlMarzooqi, Shaila Merchant, Sean Bennett, Janyssa Charbonneau, Mai-Kim Gervais, Alexandre Brind'Amour, Narcisse Singbo, Mikaël Lefebvre Soucisse, Lucas Sidéris, Guy Leblanc, Jean-François Tremblay, Pierre Dubé, Ekaterina Kouzmina, Matthew Castelo, Nicole Look Hong, Julie Hallet, Natalie Coburn, Frances Write, Lena Nguyen, Sonal Gandhi, Katarzyna Jerzak, Andrea Eisen, Amanda Roberts, Dejan Vidovic, Brianne Cruickshank, Lucy Helyer, Carman Giacomantonio, Zuhaib Mir, Matheus Faleiro, Stephanie Hiebert, Scott Livingstone, Mark Walsh, Boris Gala-Lopez, Sukhdeep Jatana, Daniel Krys, Uzair Jogiat, Janice Kung, Kevin Verhoeff, Tori Lenet, François Martin Carrier, Karine Brousseau, Franck Vandenbroucke-Menu, Yves Collin, Richard W D Gilbert, Maja Segedi, Jad Abou Khalil, Kimberly A Bertens, Fady Balaa, Dean A Fergusson, Guillaume Martel, Christopher Wherrett, Katlin Mallette, Leah Monette, Aklile Workneh, Monique Ruel, Elham Sabri, Heather Maddison, Melanie Tokessym, Patrick B Y Wong, Luc Massicotte, Michaël Chassé, Michel-Antoine Perrault, Élodie Hamel-Perreault, Jeieung Park, Shirley Lim, Véronique Maltais, Philemon Leung, Timothy Ramsay, Alan Tinmouth, Zofia Czarnecka, Nidheesh Dadheeech, Rena Pawlick, Haide Razavy, James Shapiro, Panthea Pouramin, Susan Allen, Boris Gala-Lopez, Nawal Amhis, Rachel Liu Hennessey, Yuwei Yang, Rochelle Guan, Yolanda Zhang, Adam Meneghetti, Chieh Chiu, Dhuvaraha Srikrishnaraj, Jeffrey Hawel, Christopher Schlachta, Ahmad Elnahas, Ayse Yilbas, Marguerite Mainprize, Anton Svendrovski, Christoph Paasch, Fernando Spencer Netto, Jigish Khamar, Tyler McKechnie, Amin Hatamnejad, Yung Lee, Bright Huo, Edward Passos, Niv Sne, Cagla Eskicioglu, Dennis Hong, Sean Bennett, Jennifer Flemming, Maya Djerboua, Vanessa Wiseman, Jonah Moore, Peter Szasz, Sulaiman Nanji, Jonah Moore, Vanessa Wiseman, Peter Szasz, Isis Lunsky, Sulaiman Nanji, Jennifer A Flemming, Sean Bennett, Sandra McKeown, Omar Mouhammed, Colton Gibb, Kevin Verhoeff, Michael Kim, Matt Strickland, Ram Anantha, Ilinca Georgescu, Yung Lee, Thomas Shin, Lea Tessier, Arshia Javidan, James Jung, Dennis Hong, Tyler McKechnie, Andrew Strong, Matthew Kroh, Jerry Dang, Muhammad Faran, Tyler McKechnie, Emma O'Callaghan, Sama Anvari, Taylor Hughes, Mark Crowther, Mehran Anvari, Aristithes Doumouras, Amin Andalib, Ali Safar, Philippe Bouchard, Sebastian Demyttenaere, Olivier Court, Simran Parmar, Brianna Brand, Noah Switzer, Richdeep Gil, Sunawer Aujla, Morgan Schellenberg, Natthida Owattanapanich, Brent Emigh, Jan-Michael Van Gent, Tanya Egodage, Patrick B Murphy, Chad Ball, Audrey L Spencer, Kelly N Vogt, Jessica A Keeley, Stephanie Doris, Kenji Inaba, Jordan Nantais, Nancy Baxter, Refik Saskin, Andrew Calzavara, David Gomez, Alex Le, Philip Dawe, Morad Hameed, Amir Hassanpour, Eran Shlomovitz, David Gomez, Eisar Al-Sukhni, Vanessa Wiseman, Sunil Patel, Sean Bennett, Zuhaib Mir, Stephanie Roberts, Harvey Hawes, Khalil Merali, Rachel Morris, Marc de Moya, Todd Neideen, Andrew Kastenmeier, Lewis Somberg, Dan Holena, Patrick Murphy, Jordan Nantais, Nancy Baxter, Refik Saskin, Andrew Calzavara, David Gomez, Asad Naveed, Umang Deshpande, David Gomez, Joao Rezende-Neto, Najma Ahmed, Andrew Beckett","doi":"10.1503/cjs.012624","DOIUrl":"10.1503/cjs.012624","url":null,"abstract":"","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6suppl2","pages":"S77-S108"},"PeriodicalIF":2.2,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749494","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":"Incidence and timing of postoperative complications after total hip and knee arthroplasty.","authors":"Fernando Diaz-Dilernia, Yaniv Steinfeld, Daniel Pincus, Mark Spangehl, Bheeshma Ravi","doi":"10.1503/cjs.004724","DOIUrl":"10.1503/cjs.004724","url":null,"abstract":"<p><strong>Background: </strong>Follow-up protocols after total hip or knee arthroplasty (THA or TKA, respectively) have little uniformity, which can lead to emergency department (ED) visits for postoperative complications. We sought to determine the incidence and timing of postoperative complications after THA or TKA.</p><p><strong>Methods: </strong>We conducted a population-based retrospective cohort study of all adults in Ontario who underwent primary THA or TKA between 2010 and 2019. We used data available through ICES. We identified medical and surgical complications, ED visits, and hospital readmissions using institutional databases and Ontario Health Insurance Plan claims. Outcomes included major medical complications within 30 days and surgical complications within 1 year after surgery.</p><p><strong>Results: </strong>We included 158 503 and 103 728 patients who underwent TKA and THA, respectively. The incidence of medical complications within 30 days was 2.90% after TKA and 2.42% after THA. Visits to the ED (20.0% after TKA, 16.9% after THA) and readmission rates within 30 days (3.8% after TKA, 4.1% after THA) were similar for both groups. Visits to the ED occurred at a median of 10 days after surgery for both groups, with readmissions at a median of 12 and 13 days after TKA and THA, respectively. The incidence of major TKA complications was 1.6%, with a median time of 84 (interquartile range [IQR] 26-224) days. The incidence of major THA complications was 2.2%, with a median time of 29 (IQR 16-80) days.</p><p><strong>Conclusion: </strong>Our findings suggest follow-up contact 7-10 days after THA or TKA to minimize ED visits, with at least 1 subsequent in-person follow-up at 5-6 weeks after surgery. After that, surgeons may personalize additional follow-ups as needed.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6","pages":"E377-E382"},"PeriodicalIF":2.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726279","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 impact of COVID-19 on pancreaticoduodenectomy outcomes in a hepatopancreatobiliary centre of excellence.","authors":"Helia Nabavian, Lev Bubis, Shiva Jayaraman, Melanie Tsang","doi":"10.1503/cjs.012823","DOIUrl":"10.1503/cjs.012823","url":null,"abstract":"<p><strong>Background: </strong>At the beginning of the COVID-19 pandemic, access to \"planned\" surgical care was restricted as the health care system responded to the coronavirus. We hypothesized that the pandemic resulted in diagnostic and therapeutic delays, leading to stage migration among patients with malignancies treated with a Whipple procedure.</p><p><strong>Methods: </strong>This study is a retrospective review of adults who underwent surgical exploration for a planned pancreaticoduodenectomy for malignancy at St. Joseph's Health Centre between March 11, 2019, and March 11, 2021.</p><p><strong>Results: </strong>We included 180 patients in the study. Baseline characteristics, pathologic diagnoses, and perioperative outcomes were similar between the 2 cohorts. The post-COVID group had longer median wait times from date of consent (<i>p</i> < 0.001), and from computed tomography (CT) scan (<i>p</i> < 0.001), to surgery. There were increased rates of R1 margin positivity in the post-COVID group (<i>p</i> = 0.01). We saw an association between higher wait times from consent and the last CT scan to the date of operation, and increased rates of R1 margin positivity in the first year of the pandemic.</p><p><strong>Conclusion: </strong>This study demonstrated the importance of prioritizing care during a pandemic and provided evidence for potential long-term consequences when there are delays in surgery for aggressive gastrointestinal malignancies.</p>","PeriodicalId":9573,"journal":{"name":"Canadian Journal of Surgery","volume":"67 6","pages":"E383-E388"},"PeriodicalIF":2.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726280","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}