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Canadian Journal of Surgery. Journal Canadien de Chirurgie

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https://www.readbyqxmd.com/read/29171833/patient-perceived-barriers-to-radiation-therapy-for-breast-cancer
#1
Keegan Guidolin, Michael Lock, Muriel Brackstone
Studies have shown that a number of women do not receive adjuvant radiation therapy following breast-conserving surgery; the reasons have not been well investigated. We reviewed the charts of 267 patients in our institution who did not receive radiation therapy following surgery in order to determine patientstated reasons for nonreceipt. We found that 43% of patients did not receive radiation because they received a completion mastectomy. Excluding these patients, reasons for nonreceipt of radiation therapy were sorted into 9 categories...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29171832/no-3-canadian-general-hospital-mcgill-in-the-great-war-service-and-sacrifice
#2
Andrew Beckett, Edward J Harvey
During the Great War, McGill University fielded a full general hospital to care for the wounded and sick among the Allied forces fighting in France and Belgium. The unit was designated No. 3 Canadian General Hospital (McGill) and included some of the best medical minds in Canada. Because the unit had a relationship with Sir William Osler, who was a professor at McGill from 1874 to 1885, the unit received special attention throughout the war, and legendary Canadian medical figures, such as John McCrae, Edward Archibald and Francis Scrimger, VC, served on its staff...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29171831/physical-performance-following-acute-high-risk-abdominal-surgery-a-prospective-cohort-study
#3
Line Rokkedal Jønsson, Lina Holm Ingelsrud, Line Toft Tengberg, Thomas Bandholm, Nicolai Bang Foss, Morten Tange Kristensen
BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical performance and barriers to independent mobilization among patients who received AHA surgery (postoperative days [POD] 1-7). METHODS: Patients undergoing AHA surgery were consecutively enrolled from a university hospital in Denmark...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29171830/process-mapping-as-a-framework-for-performance-improvement-in-emergency-general-surgery
#4
Kristin DeGirolamo, Karan D'Souza, William Hall, Emilie Joos, Naisan Garraway, Chad Kim Sing, Patrick McLaughlin, Morad Hameed
BACKGROUND: Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement. METHODS: We used the American College of Surgeons Emergency General Surgery Quality Improvement Program pilot database to identify patients who received nonoperative or operative management of small bowel obstruction between March 2015 and March 2016...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29171829/effect-of-patient-decision-aid-was-influenced-by-presurgical-evaluation-among-patients-with-osteoarthritis-of-the-knee
#5
Laura Boland, Monica Taljaard, Geoffrey Dervin, Logan Trenaman, Peter Tugwell, Marie-Pascale Pomey, Dawn Stacey
BACKGROUND: Decision aids help patients make total joint arthroplasty decisions, but presurgical evaluation might influence the effects of a decision aid. We compared the effects of a decision aid among patients considering total knee arthroplasty at 2 surgical screening clinics with different evaluation processes. METHODS: We performed a subgroup analysis of a randomized controlled trial. Patients were recruited from 2 surgical screening clinics: an academic clinic providing 20-minute physician consultations and a community clinic providing 45-minute physiotherapist/nurse consultations with education...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29171828/analysis-of-postdischarge-costs-following-emergent-general-surgery-in-elderly-patients
#6
Gilgamesh J Eamer, Fiona Clement, Jenelle L Pederson, Thomas A Churchill, Rachel G Khadaroo
BACKGROUND: As populations age, more elderly patients will undergo surgery. Frailty and complications are considered to increase in-hospital cost in older adults, but little is known on costs following discharge, particularly those borne by the patient. We examined risk factors for increased cost and the type of costs accrued following discharge in elderly surgical patients. METHODS: Acute abdominal surgery patients aged 65 years and older were prospectively enrolled...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29171827/comparing-the-anterior-posterior-and-lateral-approach-gait-analysis-in-total-hip-arthroplasty
#7
Stephen Petis, James Howard, Brent Lanting, Ian Jones, Trevor Birmingham, Edward Vasarhelyi
BACKGROUND: The choice of surgical approach for total hip arthroplasty (THA) remains a contentious issue with regards to clinical outcome optimization and restoring patient function. The purpose of this study was to determine the impact of surgical approach for THA on quantitative gait analysis. METHODS: Patients undergoing THA for primary osteoarthritis of the hip were assigned to 1 of 3 surgical approaches: anterior, posterior and lateral. Standardized implants were used at the time of surgery...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29171826/tertiary-care-centre-adherence-to-unified-guidelines-for-management-of-periprosthetic-joint-infections-a-gap-analysis
#8
Mitchel D Armstrong, Alberto V Carli, Hesham Abdelbary, Stephane Poitras, Peter Lapner, Paule E Beaule
BACKGROUND: The success rate of surgical treatment for periprosthetic joint infection (PJI) remains inconsistent in the literature. Variability in PJI clinical guidelines and surgeon adherence to guidelines could affect treatment success. The objectives of this study were to appraise current recommendations for PJI management and develop a unified clinical standard of care, to perform a gap analysis of PJI cases in a tertiary institution to determine the rate of guideline adherence, and to determine if adherence to unified PJI guidelines affected 2-year treatment outcomes...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29072987/can-surgical-site-infections-be-reduced-with-the-adoption-of-a-bundle-of-simultaneous-initiatives-the-use-of-nsqip-incidence-data-to-follow-multiple-quality-improvement-interventions
#9
Duncan Rozario
Surgical site infections (SSI) are a common complication after surgical procedures. To reduce the incidence of SSIs, Oakville Trafalgar Memorial Hospital decided to institute a bundle of initiatives to change multiple factors simultaneously based on best available evidence and the understanding of infection pathophysiology. We used National Surgical Quality Improvement Program data on the incidence of SSIs in our targeted and essentials, general surgery and orthopedic surgery cases before and after the implementation of an SSI reduction bundle...
October 26, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173265/evaluation-of-the-influence-of-student-led-surgery-interest-groups-a-pan-canadian-survey
#10
Jin Soo Andy Song, Connor McGuire, Alexander Morzyci, Michael Vaculik, Madeleine Plourde
No abstract text is available yet for this article.
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173264/author-response
#11
Simon T Adams, D Nathan Ginther, Evan D Neuls, Paul Hayes
No abstract text is available yet for this article.
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173263/response-to-attitudes-and-factors-contributing-to-attrition-in-canadian-surgical-specialty-residency-programs
#12
Julia B Lichtenstein
No abstract text is available yet for this article.
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173262/users-guide-to-the-surgical-literature-how-to-assess-a-noninferiority-trial
#13
Achilleas Thoma, Forough Farrokhyar, Daniel Waltho, Luis H Braga, Sheila Sprague, Charlie H Goldsmith
A well-planned randomized controlled trial (RCT) is the most optimal study design to determine if a novel surgical intervention is any different than a prevailing one. Traditionally, when we want to show that a new surgical intervention is superior to a standard one, we analyze data from an RCT to see if the null hypothesis of "no difference" can be rejected (i.e., the 2 surgical interventions have the same effect). A noninferiority RCT design seeks to determine whether a new intervention is not worse than a prevailing (standard) one within an acceptable margin of risk or benefit, referred to as the "noninferiority margin...
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173261/the-importance-of-cognitive-map-placement-in-bile-duct-injuries
#14
Francis Sutherland, Elijah Dixon
Bile duct injuries often occur because of surgeon spatial disorientation. The psychological concept of cognitive map misplacement is a useful explanation of how this disorientation and injury occurs. Surgeons may find that using a "bile duct time out" is a helpful way to orient. Based on the mnemonic B-SAFE, they can use 5 subhepatic landmarks (B, bile duct; S, sulcus of Rouviere; A, hepatic artery; F, umbilical fissure; E, enteric/duodenum) to correctly place their cognitive map.
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173260/transanal-minimally-invasive-surgery-for-benign-large-rectal-polyps-and-early-malignant-rectal-cancers-experience-and-outcomes-from-the-first-canadian-centre-to-adopt-the-technique
#15
Antonio Caycedo-Marulanda, Henry Y Jiang, Erica L Kohtakangas
BACKGROUND: Transanal minimally invasive surgery (TAMIS) has emerged as a relatively new technique in treating early cancer and benign lesion of the rectum. The technique is likely to be widely adopted, surpassing other comparable techniques owing to its simple setup and cost-effectiveness. We assessed the outcomes of TAMIS at our centre. METHODS: We retrospectively reviewed prospectively collected data on 50 patients who underwent TAMIS for benign, malignant T1 or T2 cancers that were unfit for radical surgery over a 4-year period...
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173259/optimizing-associated-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-outcomes-surgical-experience-or-appropriate-patient-selection
#16
COMPARATIVE STUDY
Ibrahim Al Hasan, Mauro Enrique Tun-Abraham, Kerollos N Wanis, Carlos Garcia-Ochoa, Mark A Levstik, Bandar Al-Judaibi, Roberto Hernandez-Alejandro
BACKGROUND: Early reports of associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) outcomes have been suboptimal. The literature has confirmed that learning curves influence surgical outcomes. We have 54 months of continuous experience performing ALPPS with strict selection criteria. This study aimed to evaluate the impact of the learning curve on ALPPS outcomes. METHODS: We retrospectively compared patients who underwent ALPPS between April 2012 and March 2016...
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173258/the-1917-halifax-explosion-the-first-coordinated-local-civilian-medical-response-to-disaster-in-canada
#17
Chryssa N McAlister, Allan E Marble, T Jock Murray
The 1917 Halifax Explosion was an unfortunate but predictable tragedy, given the sea traffic and munitions cargo, resulting in sudden large-scale damage and catastrophic injuries, with 1950 dead and 8000 injured. Although generous support was received from the United States, the bulk of the medical work was undertaken using local resources through an immediate, massive, centrally coordinated medical response. The incredible care provided 100 years ago by these Canadian physicians, nurses and students is often forgotten, but deserves attention...
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173257/training-canadian-surgeons-in-oncoplastic-breast-surgery-where-do-we-stand
#18
Eman Khayat, Muriel Brackstone, Jessica Maxwell, Renee Hanrahan, Jeannie Richardson, Marianna Kappala, Angel Arnaout
Breast-conserving surgery with adjuvant radiation therapy is widely accepted as a universal standard of care for women with early-stage breast cancer. Oncoplastic breast-conserving surgery (OPS) techniques have emerged in recent years, facilitating the achievement of better cosmetic results while adhering to good oncological principles. Compared with the rest of the international community, Canada has been fairly slow in its clinical uptake of OPS. This commentary discusses how Canada can increase its capacity for OPS...
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173256/le-dr%C3%A2-louis-kristal-%C3%A3-100%C3%A2-ans%C3%A2-t%C3%A3-moin-de-l-%C3%A3-volution-de-la-chirurgie-au-canada
#19
Vivian McAlister
No abstract text is available yet for this article.
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29173255/dr-louis-kristal-at-100-witness-to-the-evolution-of-surgery-in-canada
#20
Vivian McAlister
No abstract text is available yet for this article.
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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