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Canadian Journal of Surgery. Journal Canadien de Chirurgie

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https://www.readbyqxmd.com/read/29806807/thirty-day-hospital-readmission-and-emergency-department-visits-after-vascular-surgery-a-canadian-prospective-cohort-study
#1
Muzammil H Syed, Mohamad A Hussain, Zeyad Khoshhal, Konrad Salata, Beidaa Altuwaijri, Bertha Hughes, Norah Alsaif, Charles de Mestral, Subodh Verma, Mohammed Al-Omran
BACKGROUND: Rates of hospital readmission following surgery can serve as a marker for quality of care. The aim of this study was to establish the rates and causes of readmission and emergency department visits after vascular surgery and to understand how these patients are managed. METHODS: We conducted a prospective observational cohort study including all inpatients who underwent major vascular surgery between September 2015 and June 2016 at a tertiary vascular care centre in Toronto...
June 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806806/propofol-administration-by-endoscopists-versus-anesthesiologists-in-gastrointestinal-endoscopy-a-systematic-review-and-meta-analysis-of-patient-safety-outcomes
#2
Julian F Daza, Carolyn M Tan, Ryan J Fielding, Allison Brown, Forough Farrokhyar, Ilun Yang
BACKGROUND: With a growing demand for endoscopic services, the role of anesthesiologists in endoscopy units must be reassessed. The aim of this study was to compare patient outcomes in non-anesthesiologist-administered propofol (NAAP) versus anesthesiologist-administered propofol (AAP) during routine endoscopy. METHODS: We systematically searched Medline, CINAHL, Embase, Web of Science, CENTRAL and the grey literature for studies comparing NAAP and AAP. Primary outcomes included endoscopy- and sedation-related complications...
June 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806805/a-day-in-the-life-of-emergency-general-surgery-in-canada-a-multicentre-observational-study
#3
Kristin DeGirolamo, Karan D'Souza, Sameer Apte, Chad G Ball, Christopher Armstrong, Artan Reso, Sandy Widder, Sarah Mueller, Lawrence M Gillman, Ravinder Singh, Rahima Nenshi, Kosar Khwaja, Samuel Minor, Chris de Gara, S Morad Hameed
BACKGROUND: Emergency general surgery (EGS) services are gaining popularity in Canada as systems-based approaches to surgical emergencies. Despite the high volume, acuity and complexity of the patient populations served by EGS services, little has been reported about the services' structure, processes, case-mix or outcomes. This study begins a national surveillance effort to define and advance surgical quality in an important and diverse surgical population. METHODS: A national cross-sectional study of EGS services was conducted during a 24-hour period in January 2017 at 14 hospitals across 7 Canadian provinces recruited through the Canadian Association of General Surgeons Acute Care Committee...
June 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806804/practice-and-attitudes-regarding-double-gloving-among-staff-surgeons-and-surgical-trainees
#4
Mark E Lipson, Rob Deardon, Noah J Switzer, Chris de Gara, Chad G Ball, Sean C Grondin
BACKGROUND: Despite supporting evidence, many staff surgeons and surgical trainees do not routinely double glove. We performed a study to assess rates of and attitudes toward double gloving and the use of eye protection in the operating room. METHODS: We conducted an electronic survey among all staff surgeons and surgical trainees at 2 tertiary care centres in Alberta between September and November 2015.We analyzed the data using log-binomial regression for binary outcomes to account for multiple independent variables and interactions...
June 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806803/beyond-just-the-operating-room-characterizing-the-complete-caseload-of-a-tertiary-acute-care-surgery-service
#5
Theunis J van Zyl, Patrick B Murphy, Laura Allen, Neil G Parry, Ken Leslie, Kelly N Vogt
BACKGROUND: Most studies evaluating acute care surgery (ACS) models of care for patients with emergency general surgery (EGS) conditions have focused on patients who undergo surgery while admitted under the care of the ACS service. The purpose of this study was to prospectively examine the case-mix of admissions and consultations to an ACS service at a tertiary centre to identify the frequency and distribution of both operatively and nonoperatively managed EGS conditions. METHODS: In this prospective cohort study, we evaluated consecutive patients assessed by the ACS team between July 1 and Aug...
June 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806802/assessing-resectability-of-colorectal-liver-metastases-how-do-different-subspecialties-interpret-the-same-data
#6
Jean-Michel Aubin, Alexsander K Bressan, Sean C Grondin, Elijah Dixon, Anthony R MacLean, Sean Gregg, Patricia Tang, Gilaad G Kaplan, Guillaume Martel, Chad G Ball
BACKGROUND: Multimodal treatment of colorectal liver metastases (CRLMs) relies on precise upfront assessment of resectability. Variability in the definition of resectable disease and the importance of early consultation by a liver surgeon have been reported. In this pilot study we investigated the initial resectability assessment and patterns of referral of patients with CRLMs. METHODS: Surgeons and medical oncologists involved in the management of colorectal cancer at 2 academic institutions and affiliated community hospitals were surveyed...
June 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806819/users-guide-to-the-surgical-literature-how-to-assess-a-qualitative-study
#7
Lucas Gallo, Jessica Murphy, Luis H Braga, Forough Farrokhyar, Achilleas Thoma
Qualitative research contributes to the medical literature through the observation, description and interpretation of theories about social interactions and individual experiences as they occur in their natural setting. This type of research has the potential to enhance the understanding of surgeons' and patients' preferences, attitudes and beliefs, as well as assess how these may change with time. To date, there is no widely accepted standard for the methodological assessment of qualitative research. Despite ongoing debate, this article seeks to familiarize surgeons with the basic techniques for the critical appraisal of qualitative studies in the surgical literature...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806818/diagnostic-accuracy-of-transabdominal-ultrasonography-for-gallbladder-polyps-systematic-review
#8
Erin Martin, Richdeep Gill, Estifanos Debru
BACKGROUND: Previous research has shown variable but generally poor accuracy of transabdominal ultrasonography in the diagnosis of gallbladder polyps. We performed a systematic review of the literature with the aim of helping surgeons interpret and apply these findings in the preoperative assessment and counselling of their patients. METHODS: We searched PubMed, MEDLINE and the Cochrane database using the keywords "gallbladder," "polyp," "ultrasound," "pathology" and "diagnosis" for English-language articles published after 1990 with the full-text article available through our institutional subscriptions...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806817/clinical-and-operative-outcomes-of-patients-with-acute-cholecystitis-who-are-treated-initially-with-image-guided-cholecystostomy
#9
Ida Molavi, Angela Schellenberg, Francis Christian
BACKGROUND: Percutaneous cholecystostomy (PC) tube placement followed by delayed cholecystectomy has been shown to be an effective treatment option in high-risk populations such as older and critically ill patients. The goal of this study was to review the short- and long-term clinical and operative outcomes of patients with acute cholecystitis initially treated with PC tube placement. METHODS: We conducted a retrospective review of patients who underwent image-guided PC tube insertion between 2001 and 2011 at the Royal University Hospital or St...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806816/troponin-t-monitoring-to-detect-myocardial-injury-after-noncardiac-surgery-a-cost-consequence-analysis
#10
Giovanna Lurati Buse, Braden Manns, Andre Lamy, Gordon Guyatt, Carisi A Polanczyk, Matthew T V Chan, Chew Yin Wang, Juan Carlos Villar, Alben Sigamani, Daniel I Sessler, Otavio Berwanger, Bruce M Biccard, Rupert Pearse, Gerard Urrútia, Wojciech Szczeklik, Ignacio Garutti, Sadeesh Srinathan, German Malaga, Valsa Abraham, Clara K Chow, Michael J Jacka, Maria Tiboni, Gareth Ackland, Danielle Macneil, Robert Sapsford, Martin Leuwer, Yannick Le Manach, Philip J Devereaux
BACKGROUND: Myocardial injury after noncardiac surgery (MINS) is a mostly asymptomatic condition that is strongly associated with 30-day mortality; however, it remains mostly undetected without systematic troponin T monitoring. We evaluated the cost and consequences of postoperative troponin T monitoring to detect MINS. METHODS: We conducted a model-based cost-consequence analysis to compare the impact of routine troponin T monitoring versus standard care (troponin T measurement triggered by ischemic symptoms) on the incidence of MINS detection...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806815/tranexamic-acid-administration-to-older-patients-undergoing-primary-total-hip-arthroplasty-conserves-hemoglobin-and-reduces-blood-loss
#11
Hossam El Beheiry, Ashley Lubberdink, Nigel Clements, Kiran Dihllon, Vicky Sharma
BACKGROUND: Tranexamic acid effects in older people are difficult to predict. This study investigated the following research questions: 1) Is tranexamic acid effective in older patients undergoing primary total hip arthroplasty (THA)? and 2) Is there a difference in the effect of tranexamic acid between younger and older patients? METHODS: This was a 2-phase retrospective matched-pair study of patients who underwent THA in 2007-2013. All procedures were performed by surgeons with at least 10 years' experience as senior consultant...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806814/risk-factors-for-infection-revision-death-blood-transfusion-and-longer-hospital-stay-3-months-and-1-year-after-primary-total-hip-or-knee-arthroplasty
#12
Chanseok Rhee, Lynn Lethbridge, Glen Richardson, Michael Dunbar
BACKGROUND: Total joint replacement (TJR) is increasingly performed in older patients with more comorbidities, who are considered at higher risk for postoperative complications. We aimed to identify and calculate the odds ratio of the risk factors for infection, revision and death 3 months and 1 year after TJR as well as for postoperative blood transfusion and longer hospital stay. METHODS: We analyzed all primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) cases in Nova Scotia between Apr...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806813/management-of-intra-abdominal-vascular-injury-in-trauma-laparotomy-a-south-african-experience
#13
Ross Weale, Victor Kong, Vassil Manchev, Wanda Bekker, George Oosthuizen, Petra Brysiewicz, Grant Laing, John Bruce, Damian Clarke
BACKGROUND: Intra-abdominal vascular injury (IAVI) is uncommon but continues to be associated with high mortality rates despite technological advances in the past decades. In light of these ongoing developments, we reviewed our contemporary experience with IAVI in an attempt to clarify and refine our management strategies and the outcome of these patients. METHODS: We retrospectively reviewed the charts of all patients admitted between January 2011 and December 2014 at a major trauma centre in South Africa who were found to have an IAVI during laparotomy for trauma...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806812/massacre-of-canadian-army-medical-corps-personnel-after-the-sinking-of-hmhs-llandovery-castle-and-the-evolution-of-modern-war-crime-jurisprudence
#14
Jay Doucet, Gregory Haley, Vivian McAlister
Events after the sinking of the hospital ship Llandovery Castle on June 27, 1918, by the German submarine U-86 outraged Canadians. Survivors aboard a single life raft gave evidence that many of the 234 souls lost had made it to lifeboats but were rammed and shot by the submarine. Many of those who died were nurses. Three German officers were charged with war crimes after the war. The submarine's captain evaded capture. The remaining two officers' defence that they were following the captain's orders failed and they were convicted...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806811/the-current-state-of-resident-trauma-training-are-we-losing-a-generation
#15
Paul T Engels, Nori L Bradley, Chad G Ball
General surgeons provide life-saving trauma care to a large portion of Canadians. Although trauma care has evolved significantly over the last few decades and now requires fewer operations, when a life-saving operation is required the expectation of competence to perform this operation has not been reduced. A recent study from the United States found decreased resident case-log volumes of trauma operations. Such findings raise the alarm of declining exposure of residents to trauma operations and beg the question of whether graduating residents are competent to care for trauma patients...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806810/one-thousand-consecutive-in-hospital-deaths-following-severe-injury-has-the-etiology-of-traumatic-inpatient-death-changed-in-canada
#16
Derek J Roberts, Christina Harzan, Andrew W Kirkpatrick, Elijah Dixon, Sean C Grondin, Paul B McBeth, Gilaad G Kaplan, Chad G Ball
A wide range of factors have traditionally led to early in-hospital death following severe injury. The primary goal of this commentary was to evaluate the causes of early posttraumatic inpatient deaths over an extended period. Although early posttraumatic in-hospital death remains multifactorial, severe traumatic brain injuries are the dominant cause and have increased in proportion over time. Other traditional causes of death have also decreased owing to improved clinical care.
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806809/r%C3%A3-sultats-chez-les-patients-ou-r%C3%A3-sultats-financiers-que-faut-il-prioriser
#17
(no author information available yet)
No abstract text is available yet for this article.
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29806808/patient-outcomes-versus-financial-outcomes-which-should-we-listen-to
#18
(no author information available yet)
No abstract text is available yet for this article.
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29583119/management-of-intra-abdominal-vascular-injury-in-trauma-laparotomy-a-south-african-experience
#19
Ross Weale, Victor Kong, Vassil Manchev, Wanda Bekker, George Oosthuizen, Petra Brysiewicz, Grant Laing, John Bruce, Damian Clarke
BACKGROUND: Intra-abdominal vascular injury (IAVI) is uncommon but continues to be associated with high mortality rates despite technological advances in the past decades. In light of these ongoing developments, we reviewed our contemporary experience with IAVI in an attempt to clarify and refine our management strategies and the outcome of these patients. METHODS: We retrospectively reviewed the charts of all patients admitted between January 2011 and December 2014 at a major trauma centre in South Africa who were found to have an IAVI during laparotomy for trauma...
April 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29583118/the-current-state-of-resident-trauma-training-are-we-losing-a-generation
#20
Paul T Engels, Nori L Bradley, Chad G Ball
General surgeons provide life-saving trauma care to a large portion of Canadians. Although trauma care has evolved significantly over the last few decades and now requires fewer operations, when a life-saving operation is required the expectation of competence to perform this operation has not been reduced. A recent study from the United States found decreased resident case-log volumes of trauma operations. Such findings raise the alarm of declining exposure of residents to trauma operations and beg the question of whether graduating residents are competent to care for trauma patients...
April 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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