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1. Ventilation Defect Burden Quantified by Technegas SPECT and 129Xe MRI Predicts Lung Cancer Resection Outcomes

Author

Radadia, N., primary, Priel, E., additional, Friedlander, Y., additional, Konyer, N., additional, Huang, C., additional, Jamal, M., additional, Farncombe, T., additional, Marriott, C., additional, Finley, C., additional, Agzarian, J., additional, Noseworthy, M., additional, Nair, P., additional, Shargall, Y., additional, and Svenningsen, S., additional

Published
2024
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3. Impact of frailty on hiatal hernia repair: a nationwide analysis of in-hospital clinical and healthcare utilization outcomes.

Author

Lee, Y, Huo, B, McKechnie, T, Agzarian, J, and Hong, D

Subjects
HERNIA surgery, HIATAL hernia, OLDER patients, FRAILTY, LENGTH of stay in hospitals, HOSPITAL mortality, OPERATING room nursing
Abstract

Previous studies recommend a watch-and-wait approach to paraesophageal hernia (PEH) repair due to an increased risk for mortality. While contemporary studies suggest that elective surgery is safe and effective, many patients presenting with PEH are elderly. Therefore, we assessed the impact of frailty on in-hospital outcomes and healthcare utilization among patients receiving PEH repair. This retrospective population-based cohort study assessed patients from the National Inpatient Sample database who received PEH repair between October 2015 to December 2019. Demographic and perioperative data were gathered, and frailty was measured using the 11-item modified frailty index. The outcomes measured were in-hospital mortality, complications, discharge disposition, and healthcare utilization. Overall, 10,716 patients receiving PEH repair were identified, including 1442 frail patients. Frail patients were less often female and were more often in the lowest income quartile compared to robust patients. Frail patients were at greater odds for in-hospital mortality [odds ratio (OR) 2.83 (95% CI 1.65–4.83); P  < 0.001], postoperative ICU admissions [OR 2.07 (95% CI 1.55–2.78); P  < 0.001], any complications [OR 2.18 (95% CI 1.55–2.78); P  < 0.001], hospital length of stay [mean difference (MD) 1.75 days (95% CI 1.30–2.210; P  < 0.001], and total admission costs [MD $5631.65 (95% CI $3300.06–$7.963.24); P  < 0.001] relative to their robust patients. While PEH repair in elderly patients is safe and effective, frail patients have an increased rate of in-hospital mortality, postoperative ICU admissions, complications, and total admission costs. Clinicians should consider patient frailty when identifying the most appropriate surgical candidates for PEH repair. [ABSTRACT FROM AUTHOR]

Published
2023
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5. 03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population

Author

Johnson, G., Vergis, A., Unger, B., Park, J., Gillman, L., Hickey, K., Pace, D., Azin, A., Guidolin, K., Lam-Tin-Cheung, K., Chadi, S., Quereshy, F., Catton, J., Rubin, B., Bell, J., Marangos, J., Heesters, A., Stuart-McEwan, T., Shariff, F., Wright, F., Ahmed, N., Nadler, A., Hallet, J., Gentles, J., Chen, L., Hwang, H., Parapini, M., Hirpara, D., Sidhu, R., Scott, T., Karimuddin, A., Guo, R., Nguyen, A., Osborn, J., Wiseman, S., Nabata, K., Ertel, E., Lenet, T., Baker, L., Park, L., Vered, M., Zahrai, A., Shorr, R., Davis, A., McIsaac, D., Tinmouth, A., Fergusson, D., Martel, G., Rummel, S., Stefic-Cubic, M., Stewart, M., Melck, A., McKechnie, T., Anpalagan, T., Ichhpuniani, S., Lee, Y., Ramji, K., Eskicioglu, C., Zhu, A., Deng, S., Greene, B., Tsang, M., Palter, V., Jayaraman, S., Mann, A., Tittley, J., Cadeddu, M., Nguyen, M., Madani, A., Pasternak, J., Hong, D., Qu, L., Istl, A., Tang, E., Gray, D., Zuckerman, J., Coburn, N., Callum, J., McLeod, R., Pearsall, E., Lin, Y., Turgeon, A., Mahar, A., Kammili, A., Kriviraltcheva-Kaneva, P., Lee, L., Cools-Lartigue, J., Ferri, L., Mueller, C., Haas, B., Tillman, B., Guttman, M., Chesney, T., Zuk, V., Hsu, A., Chan, W., Vasdev, R., D’Souza, K., Huynh, C., Ling, L. Cadili J., Warburton, R., Hameed, M., Glass, L., Williamson, H., Murphy, P., Leslie, K., Hawel, J., Kerr, L., Zablotny, S., Roldan, H., He, W., Jiang, X., Zheng, B., Fiore, J., Feldman, L., Fried, G., Valanci, S., Balvardi, S., Cipolla, J., Kaneva, P., Demyttenaere, S., Boutros, M., Alhashemi, M., Miles, A., Purich, K., Verhoeff, K., Shapiro, J., Bigam, D., Kung, J., Fecso, A., Mosko, J., Skubleny, D., Hamilton, P., Ghosh, S., Widder, S., Schiller, D., Do, U., El Kefraoui, C., Pook, M., Barone, N., Montgomery, H., Nguyen-Powanda, P., Rajabiyazdi, F., Elhaj, H., Lapointe-Gagner, M., Olleik, G., Antoun, A., Safa, N., Di Lena, E., Meterissian, S., Meguerditchian, A., Lee, F., Baldini, G., Serrano Aybar, P.E., Parpia, S., Ruo, L., Tywonek, K., Lee, S., O’Neill, C., Faisal, N., Alfayyadh, A., Gundayao, M., Meyers, B.M., Habashi, R., Kruse, C., Levin, M., Aldrich, K., Grantcharov, T., Langerman, A., Forbes, H., Anantha, R., Fawcett, V., Hetherington, A., Pravong, V., Gervais, M., Rakovich, G., Selvam, R., Hu, R., Musselman, R., Raiche, I., Moloo, H., Liu, R., Elnahas, A., Alkhamesi, N., Alnumay, A., Schlachta, C., Walser, E., Zhang, C., Cristancho, S., Ott, M., Lee, A., Niu, B., Balaa, F., Gawad, N., Ren, K., Qiu, Y., Hamann, K., How, N., Leveille, C., Davidson, A., Eqbal, A., Sardiwalla, Y., Korostensky, M., Lee, E., Yang, I., Muaddi, H., Stukel, T., de Mestral, C., Nathens, A., Karanicolas, P., Frigault, J., Lemieux, S., Breton, D., Bouchard, P., Bouchard, A., Grégoire, R., Letarte, F., Bouchard, G., Drolet, S., Avoine, S., Gagné, J., Thibault, C., Jutras Bouthillette, N., Gosselin, M., Rosenzveig, A., Stuleanu, T., Jarrar, A., Kolozsvari, N., Skelhorne-Gross, G., Nenshi, R., Jerath, A., Gomez, D., Singh, K., Amir, T., Liu, E., Farquharson, S., Mao, R., Lan, L., Yan, J., Allard-Coutu, A., Mierzwa, A., Tin, R., Brisebois, R., Bradley, N., Wigen, R., Hartford, L., Van Koughnett, J., Vogt, K., Hilsden, R., Parry, N., Allen, L., Raskin, R., Jones, J., Neumann, K., Dwyer, C., Strickland, M., O’Dochartaigh, D., Lobay, K., Kabaroff, A., Chang, E., Sun, W., Beck, J., Davidson, J., Jones, S., Van Hooren, T., Schmitz, E., El Hafid, M., Dang, J., Mocanu, V., Lutzak, G., Sultanian, R., Wong, C., Karmali, S., Petrera, M., Pickell, M., Auer, R., Patro, N., Li, B., Wilson, H., Jogiat, U., Switzer, N., Li, C., Al Hinai, A., Cieply, A., Hawes, H., Joos, E., Saleh, A., Engels, P., Drung, J., Pang, G., Kwong, M., Ellsmere, J., Chang, D., Hutter, M., Spence, R., Abou Khalil, M., Vasilevsky, C., Morin, N., Longtin, Y., Liberman, S., Montpetit, P., Poirier, M., Mukherjee, K., Sebajang, H., Younan, R., Schwenter, F., De Broux, E., Larsen, K., Beckett, A., Nantais, J., Kay, J., Lohre, R., Ayeni, O., Goel, D., de SA, D., He, R., Hylton, D., Bedard, E., Johnson, S., Laing, B., Valji, A., Hanna, W., Turner, S., Akhtar-Danesh, G., Akhtar-Danesh, N., Shargall, Y., Gupta, V., Kidane, B., Limbachia, J., Sullivan, K., Farrokhyar, F., Leontiadis, G., Patel, Y., Churchill, I., Xie, F., Seely, A., Spicer, J., Yasufuku, K., Beauchamp, M., Wald, J., Mbuagbaw, L., Agzarian, J., Finley, C., Fahim, C., Abbas, M., Olaiya, O., Begum, H., Ednie, A., Palma, D., Warner, A., Malthaner, R., Fortin, D., Qiabi, M., Nayak, R., Nguyen, T., Louie, A., Rodrigues, G., Yaremko, B., Laba, J., Inculet, R., Alaichi, J., Mador, B., Lai, H., White, J., Kim, M., Darling, G., Rousseau, M., Samarasinghe, Y., Lee, M., Thiru, L., Levine, O., Juergens, R., Brogly, S., Li, W., Lougheed, D., Petsikas, D., Mistry, N., Gatti, A., Abdul, S., Anestee, C., Gilbert, S., Sundaresan, S., Villeneuve, P., Maziak, D., Razzak, R., Ashrafi, A., Tregobov, N., Hassanzadeh, N., Stone, S., Panjwani, A., Bong, T., Bond, R., Hafizi, A., De Meo, M., Rayes, R., Milette, S., Vagai, M., Usatii, M., Chandrasekaran, A., Giannias, B., Bourdeau, F., Sangwan, V., Bertos, N., Moraes, C., Huang, S., Quail, D., Walsh, L., Camilleri-Broet, S., Fiset, P., Bilgic, E., Quaiattini, A., Maurice-Ventouris, M., Najmeh, S., Esther, L., Lu, J., Malhan, R., Brophy, S., Brennan, K., French, D., Resende, V., Momtazi, M., Solaja, O., Sisson, D., Donahoe, L., Bedard, P., Hansen, A., De Perrot, M., Alghamedi, A., Simone, A., Huang, J., Murthy, S., Lin, J., Li, H., Crowther, M., Linkins, L., Lau, E., Schneider, L., Douketis, J., Greenberg, B., Allen-Avodabo, C., Davis, L., Zhao, H., Sirois, C., Mulder, D., Al Rawahi, A., Aftab Abdul, S., Nguyen, D., Anstee, C., Delic, E., Sasewich, H., Islam, T., Low, D., Humer, M., Le Nguyen, D., Kay, M., Shayegan, B., Adili, A., Kaafarani, M., Chouiali, F., Muthukrishnan, N., Maleki, F., Ovens, K., Gold, M., Sorin, M., Falutz, R., Forghani, R., Hunka, N., Kennedy, R., Bigsby, R., Bharadwaj, S., Gowing, S., Pearce, K., Jones, D., Kumar, S., Gingrich, M., Ahmadzai, Z., Thavorn, K., Namavarian, A., Mohammed, A., Uddin, S., Behzadi, A., Brar, A., Peters, E., Buduhan, G., Tan, L., Srinathan, S., Levy, J., Ringash, J., Sutradhar, R., Robinson, M., Bednarek, L., Wang, H., MacDonald, D., Graham, K., Enns, S., Tan, A., Bruinooge, A., Poole, E., Pascoe, C., Karakach, T., Halayko, A., Fang, B., Birch, D., Singh, H., Hershorn, O., Hochman, D., Helewa, R., Robertson, R., Cahill, C., Lipson, M., Afzal, A., Maclean, A., Roen, S., Buie, W., Chu, M., Amin, N., Jaffer, H., Rebello, R., Doumouras, A., Hajjar, R., Oliero, M., Cuisiniere, T., Fragoso, G., Calvé, A., Djediai, S., Annabi, B., Richard, C., Santos, M., Zhou, Y., Dodd), S., Ring, B., Yuan, Y., Garfinkle, R., Dell’Aniello, S., Bhatnagar, S., Ghitulescu, G., Faria, J., Brassard, P., Salama, E., Amar-Zifkin, A., Talwar, G., Daniel, R., AlSulaim, H., Alqahtani, M., Al-Masrouri, S., Chen, A., Patel, A., Brissette, V., Al Busaidi, N., Moon, J., Demian, M., MacRae, H., Alam, F., Holland, J., Cwintal, M., Rigas, G., Pang, A., Marinescu, D., Brown, C., Raval, M., Phang, P., Ghuman, A., Li, M., Muncner, S., Mihajlovic, I., Dykstra, M., Snelgrove, R., Monton, O., Smith, A., AlAamer, O., AlSelaim, N., AlMalki, M., Al-osail, A., Ruxton, R., Manuel, P., Mohamed, F., Motamedi, M.K., Serahati, S., Rajendran, L., Phang, T., Caminsky, N., Alavi, K., Paquette, I., MacLean, T., Wexner, S., Steele, S., Patel, S., Bordeianou, L., Sylla, P., Bayat, Z., Kennedy, E., Victor, C., Govindarajan, A., Liang, J., Roy, H., Baig, Z., Karimmudin, A., Gill, D., Ginther, N., Alrashid, F., Wiseman, V., Zhang, L., MacDonald, P., Merchant, S.M., Wattie Barnett, K., Caycedo-Marulanda, A., Patel, S.V., Harra, Z., Hegagi, M., Alghaithi, N., Papillon, E., Kasteel, N., Kaur, G., Bindra, S., Malhotra, A., Graham, C., MacLean, A., Beck, P., Jijon, H., Ferraz, J., Szwimer, R., Merchant, S., Kong, W., Gyawali, B., Hanna, T., Chung, W., Nanji, S., Booth, C., Li, V., Awan, A., Serrano, P., Jacobson, M., Chanco, M., Wen, V., Singh, N., Peiris, L., Pasieka, J., Ghatage, P., Buie, D., Bouchard-Fortier, A., Mack, L., Marini, W., Zheng, W., Swallow, C., Reedijk, M., DiPasquale, A., Prus-Czrnecka, Z., Delmar, L., Gagnon, N., Villiard, R., Martel, É., Cadrin-Chênevert, A., Ledoux, É., Racicot, C., Mysuria), S., Bazzarelli, A., Pao, J., Zhang, M., McKevitt, E., Kuusk, U., Van Laeken, N., Bovill, E., Isaac, K., Dingee, C., Hunter-Smith, A., Cuthbert, C., Fergus, K., Barbera, L., Efegoma, Y., Howell, D., Isherwood, S., Levasseur, N., Scheer, A., Simmons, C., Srikantham, A., Temple-Orberle, C., Xu, Y., Metcalfe, K., Quan, M., Alqaydi, A., la, J., Digby, G., Brind’Amour, A., Sidéris, L., Dubé, P., De Guerke, L., Fortin, S., Auclair, M., Trilling, B., Tremblay, J., Di Lena, É., Hopkins), B., Wong, S., Hopkins, B., Dumitra, S., Mysuria, S., Kapur, H., Bazarelli, A., Cadili, L., DeGirolamo, K., Ng, D., Ali, A., Eymae, D., Lee, K., Brar, S., Conner, J., Magalhaes, M., Allen, K., Baliski, C., Cyr, D., Sari, A., Messenger, D., Driman, D., Assarzadegan, N., Juda, A., Brar, M., Kirsch, R., Lamontagne, A., Gamache, Y., Mardinger, C., Lee, C., Duckworth, R., Brindle, M., Fraulin, F., Austen, L., Kortbeek, J., Hyndman, M., Jamjoum, G., Langer, S., Yuan Xu, Y., Kong, S., Lim, D., Retrouvey, H., Kerrebijn, I., Butler, K., O’Neill, A., Cil, T., Zhong, T., Hofer, S., McCready, D., Look Hong, N., Skipworth, J., Mah, A., Desai, S., Chung, S., Scudamore, C., Segedi, M., Vasilyeva, E., Li, J., Kim, P., Deprato, A., Dajani, K., Gilbert, R., Smoot, R., Tzeng, C., Rocha, F., Yohanathan, L., Cleary, S., Bertens, K., Reyna-Sepulveda, F., Badrudin, D., Gala-Lopez, B., Hanna, N., Wei, X., Kaliwal, Y., Wei, A., Henault, D., Barrette, B., Pelletier, S., Thebault, P., Beaudry-Simoneau, E., Rong, Z., Plasse, M., Dagenais, A. Roy M., Létourneau, R., Lapointe, R., Vandenbroucke-Menu, F., Nguyen, B., Soucy, G., Turcotte, S., Lemke, M., Waugh, E., Quan, D., Skaro, A., Lund, M., Glinka, J., Jada, G., Daza, J., Msallak, H., Zhang, B., Workneh, A., Faisal, S., Faisal, R., Fabbro, M., Gu, C., Claassen, M., Sapisochin, G., Breadner, D., Welch, S., Webb, A., Lester, E., Shapiro, A., Eurich, D., Essaji, Y., Shrader, H., Nayyar, A., Suraju, M., Williams-Perez, S., Ear, P., Chan, C., Smith, V., Rivers-Bowerman, M., Costa, A., Stueck, A., Campbell, N., Allen, S., Mir, Z., Golding, H., McKeown, S., Flemming, J., Groome, P., Djerboua, M., Elbekri, S., Girard, E., Morency-Potvin, P., Dagenais, M., Roy, A., Letourneau, R., Simoneau, E., Zuker, N., Oakley, M., Chartrand, G., Misheva, B., Bendavid, Y., Melland-Smith, M., Smith, L., Tan, J., Kahn, U., McLean, C., Fortin, M., Paré, X., Doyon, A., Keshavjee, S., Schwenger, K., Yadav, J., Fischer, S., Jackson, T., Allard, J., Okrainec, A., Anvari, S., Lovrics, O., Aditya, I., Khondker, A., Walsh, M., Hardy, K., Romanescu, R., Deaninck, F., Linton, J., Fowler-Woods, M., Fowler-Woods, A., Shingoose, G., Zmudzinski, M., Cloutier, Z., Archer, V., Shiroky, J., Abu Halimah, J., Boudreau, V., Marcil, G., Hardy-Henry, A., Lin, W., Hagen, J., and Connell, M.

Subjects
Abstracts, Canadian Association of General Surgeons, Canadian Hernia Society, Canada, Canadian Association of Thoracic Surgeons, Canadian Hepato-Pancreato-Biliary Association, Humans, Canadian Society of Surgical Oncology, Canadian Association of Bariatric Physicians and Surgeons, Canadian Society of Colon and Rectal Surgeons
Published
2022

6. 2021 Canadian Surgery Forum01. Design and validation of a unique endoscopy simulator using a commercial video game03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population04. Racial disparities in surgery — a cross-specialty matched comparison between black and white patients05. Starting late does not increase the risk of postoperative complications in patients undergoing common general surgical procedures06. Ethical decision-making during a health care crisis: a resource allocation framework and tool07. Ensuring stability in surgical training program leadership: a survey of program directors08. Introducing oncoplastic breast surgery in a community hospital09. Leadership development programs for surgical residents: a review of the literature10. Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: a systematic review and meta-analysis11. Timing of ERCP relative to cholecystectomy in patients with ductal gallstone disease12. A systematic review and meta-analysis of randomized controlled trials comparing intraoperative red blood cell transfusion strategies13. Postoperative outcomes after frail elderly preoperative assessment clinic: a single-institution Canadian perspective14. Selective opioid antagonists following bowel resection for prevention of postoperative ileus: a systematic review and meta-analysis15. Peer-to-peer coaching after bile duct injury16. Laparoscopic median arcuate ligament release: a video abstract17. Retroperitoneoscopic approach to adrenalectomy19. Endoscopic Zenker diverticulotomy: a video abstract20. Variability in surgeons’ perioperative management of pheochromocytomas in Canada21. The contribution of surgeon and hospital variation in transfusion practice to outcomes for patients undergoing elective gastrointestinal cancer surgery: a population-based analysis22. Perioperative transfusions for gastroesophageal cancers: risk factors and short- and long-term outcomes23. The association between frailty and time alive and at home after cancer surgery among older adults: a population-based analysis24. Psychological and workplace-related effects of providing surgical care during the COVID-19 pandemic in British Columbia, Canada25. Safety of venous thromboembolism prophylaxis in endoscopic retrograde cholangiopancreatography: a systematic review26. Complications and reintervention following laparoscopic subtotal cholecystectomy: a systematic review and meta-analysis27. Synchronization of pupil dilations correlates with team performance in a simulated laparoscopic team coordination task28. Receptivity to and desired design features of a surgical peer coaching program: an international survey9. Impact of the COVID-19 pandemic on rates of emergency department utilization due to general surgery conditions30. The impact of the current COVID-19 pandemic on the exposure of general surgery trainees to operative procedures31. Association between academic degrees and research productivity: an assessment of academic general surgeons in Canada32. Laparoscopic endoscopic cooperative surgery (LECS) for subepithelial gastric lesion: a video presentation33. Effect of the COVID-19 pandemic on acute care general surgery at an academic Canadian centre34. Opioid-free analgesia after outpatient general surgery: a pilot randomized controlled trial35. Impact of neoadjuvant immunotherapy or targeted therapies on surgical resection in patients with solid tumours: a systematic review and meta-analysis37. Surgical data recording in the operating room: a systematic review of modalities and metrics38. Association between nonaccidental trauma and neighbourhood socioeconomic status during the COVID-19 pandemic: a retrospective analysis39. Laparoscopic repair of a transdiaphragmatic gastropleural fistula40. Video-based interviewing in medicine: a scoping review41. Indocyanine green fluorescence angiography for prevention of anastomotic leakage in colorectal surgery: a cost analysis from the hospital payer’s perspective43. Perception or reality: surgical resident and faculty assessments of resident workload compared with objective data45. When illness and loss hit close to home: Do health care providers learn how to cope?46. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial47. The evolving use of robotic surgery: a population-based analysis48. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies49. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study on anastomotic complications50. A lay of the land — a description of Canadian academic acute care surgery models51. Emergency general surgery in Ontario: interhospital variability in structures, processes and models of care52. Trauma 101: a virtual case-based trauma conference as an adjunct to medical education53. Assessment of the National Surgical Quality Improvement Program Surgical Risk Calculator for predicting patient-centred outcomes of emergency general surgery patients in a Canadian health care system54. Sustainability of a narcotic reduction initiative: 1 year following the Standardization of Outpatient Procedure (STOP) Narcotics Study55. Barriers to transanal endoscopic microsurgery referral56. Geospatial analysis of severely injured rural patients in a geographically complex landscape57. Implementation of an incentive spirometry protocol in a trauma ward: a single-centre pilot study58. Impostor phenomenon is a significant risk factor for burnout and anxiety in Canadian resident physicians: a cross-sectional survey59. Understanding the influence of perioperative education on performance among surgical trainees: a single-centre experience60. The effect of COVID-19 pandemic on current and future endoscopic personal protective equipment practices: a national survey of 77 endoscopists61. Case report: delayed presentation of perforated sigmoid diverticulitis as necrotizing infection of the lower limb62. Investigating disparities in surgical outcomes in Canadian Indigenous populations63. Fundoplication is superior to medical therapy for Barrett esophagus disease regression and progression: a systematic review and meta-analysis64. Development of a novel online general surgery learning platform and a qualitative preimplementation analysis65. Hagfish slime exudate as a potential novel hemostatic agent: developing a standardized assessment protocol66. The effect of the first wave of the COVID-19 pandemic on surgical oncology case volumes and wait times67. Safety of same-day discharge in high-risk patients undergoing ambulatory general surgery68. External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement69. Improved morbidity and gastrointestinal restoration rates without compromising survival rates for diverting loop ileostomy with colonic lavage versus total abdominal colectomy for fulminant Clostridioides difficile colitis: a multicentre retrospective cohort study70. Potential access to emergency general surgical care in Ontario71. Immersive virtual reality (iVR) improves procedural duration, task completion and accuracy in surgical trainees: a systematic review01. Clinical validation of the Canada Lymph Node Score for endobronchial ultrasound02. Venous thromboembolism in surgically treated esophageal cancer patients: a provincial population-based study03. Venous thromboembolism in surgically treated lung cancer patients: a population-based study04. Is frailty associated with failure to rescue after esophagectomy? A multi-institutional comparative analysis of outcomes05. Routine systematic sampling versus targeted sampling of lymph nodes during endobronchial ultrasound: a feasibility randomized controlled trial06. Gastric ischemic conditioning reduces anastomotic complications in patients undergoing esophagectomy: a systematic review and meta-analysis07. Move For Surgery, a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial08. In case of emergency, go to your nearest emergency department — Or maybe not?09. Does preoperative SABR increase the risk of complications from lung cancer resection? A secondary analysis of the MISSILE trial10. Segmental resection for lung cancer: the added value of near-infrared fluorescence mapping diminishes with surgeon experience11. Toward competency-based continuing professional development for practising surgeons12. Stereotactic body radiotherapy versus surgery in older adults with NSCLC — a population-based, matched analysis of long-term dependency outcomes13. Role of adjuvant therapy in esophageal cancer patients after neoadjuvant therapy and curative esophagectomy: a systematic review and meta-analysis14. Evaluation of population characteristics on the incidence of thoracic empyema: an ecological study15. Determining the optimal stiffness colour threshold and stiffness area ratio cut-off for mediastinal lymph node staging using EBUS elastography and AI: a pilot study16. Quality assurance on the use of sequential compression stockings in thoracic surgery (QUESTs)17. The relationship between fissureless technique and prolonged air leak for patients undergoing video-assisted thoracoscopic lobectomy18. CXCR2 inhibition as a candidate for immunomodulation in the treatment of K-RAS-driven lung adenocarcinoma19. Assessment tools for evaluating competency in video-assisted thoracoscopic lobectomy: a systematic review20. Understanding the current practice on chest tube management following lung resection among thoracic surgeons across Canada21. Effect of routine jejunostomy tube insertion in esophagectomy: a systematic review and meta-analysis22. Recurrence of primary spontaneous pneumothorax following bullectomy with pleurodesis or pleurectomy: a retrospective analysis23. Surgical outcomes following chest wall resection and reconstruction24. Outcomes following surgical management of primary mediastinal nonseminomatous germ cell tumours25. Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non–small cell lung cancer? A single-centre propensity matching analysis26. Competency assessment for mediastinal mass resection and thymectomy: design and Delphi process27. The contemporary significance of venous thromboembolism (deep venous thrombosis [DVT] and pulmonary embolus [PE]) in patients undergoing esophagectomy: a prospective, multicentre cohort study to evaluate the incidence and clinical outcomes of VTE after major esophageal resections28. Esophageal cancer: symptom severity at the end of life29. The impact of pulmonary artery reconstruction on postoperative and oncologic outcomes: a systematic review30. Association with surgical technique and recurrence after laparoscopic repair of paraesophageal hernia: a single-centre experience31. Enhanced recovery after surgery (ERAS) in esophagectomy32. Surgical treatment of esophageal cancer: trends in surgical approach and early mortality at a single institution over the past 18 years34. Adverse events and length of stay following minimally invasive surgery in paraesophageal hernia repair35. Long-term symptom control comparison of Dor and Nissen fundoplication following laparoscopic para-esophageal hernia repair: a retrospective analysis36. Willingness to pay: a survey of Canadian patients’ willingness to contribute to the cost of robotic thoracic surgery37. Radiomics in early-stage lung adenocarcinoma: a prediction tool for tumour immune microenvironments38. Effectiveness of intraoperative pyloric botox injection during esophagectomy: how often is endoscopic intervention required?39. An artificial intelligence algorithm for predicting lymph node malignancy during endobronchial ultrasound40. The effect of major and minor complications after lung surgery on length of stay and readmission41. Measuring cost of adverse events following thoracic surgery: a scoping review42. Laparoscopic paraesophageal hernia repair: characterization by hospital and surgeon volume and impact on outcomes43. NSQIP 5-Factor Modified Frailty Index predicts morbidity but not mortality after esophagectomy44. Trajectory of perioperative HRQOL and association with postoperative complications in thoracic surgery patients45. Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centres46. Patient-reported pretreatment health-related quality of life (HRQOL) predicts short-term survival in esophageal cancer patients47. Analgesic efficacy of surgeon-placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective noninferiority study48. Rapid return to normal oxygenation after lung surgery49. Examination of local and systemic inflammatory changes during lung surgery01. 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Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study09. Improvement of colonic anastomotic healing in mice with oral supplementation of oligosaccharides10. How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer?11. Assessment of long-term bowel dysfunction in rectal cancer survivors: a population-based cohort study12. Observational versus antibiotic therapy for acute uncomplicated diverticulitis: a noninferiority meta-analysis based on a Delphi consensus13. Radiotherapy alone versus chemoradiotherapy for stage I anal squamous cell carcinoma: a systematic review and meta-analysis14. Is the Hartmann procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 201515. Sugammadex in colorectal surgery: a systematic review and meta-analysis16. 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Author

Johnson, G., primary, Hickey, K., primary, Azin, A., primary, Guidolin, K., primary, Shariff, F., primary, Gentles, J., primary, Parapini, M., primary, Guo, R., primary, Ertel, E., primary, Lenet, T., primary, Nabata, K., primary, McKechnie, T., primary, Zhu, A., primary, Nguyen, M., primary, Qu, L., primary, Zuckerman, J., primary, Kammili, A., primary, D’Souza, K., primary, Glass, L., primary, Kerr, L., primary, He, W., primary, Lee, L., primary, Balvardi, S., primary, Miles, A., primary, Fecso, A., primary, Skubleny, D., primary, Do, U., primary, Serrano Aybar, P.E., primary, Kruse, C., primary, Forbes, H., primary, Pravong, V., primary, Selvam, R., primary, Liu, R., primary, Walser, E., primary, Lee, A., primary, Ren, K., primary, Muaddi, H., primary, Frigault, J., primary, Rosenzveig, A., primary, Skelhorne-Gross, G., primary, Singh, K., primary, Mierzwa, A., primary, Wigen, R., primary, Raskin, R., primary, Dwyer, C., primary, Sun, W., primary, Schmitz, E., primary, Patro, N., primary, Wilson, H., primary, Li, C., primary, Drung, J., primary, Pang, G., primary, Abou Khalil, M., primary, Larsen, K., primary, Lan, L., primary, He, R., primary, Akhtar-Danesh, G., primary, Hirpara, D., primary, Sullivan, K., primary, Jogiat, U., primary, Patel, Y., primary, Abbas, M., primary, Ednie, A., primary, Alaichi, J., primary, Turner, S., primary, Lee, Y., primary, Nayak, R., primary, Mistry, N., primary, Abdul, S., primary, Razzak, R., primary, De Meo, M., primary, Esther, L., primary, Brophy, S., primary, Resende, V., primary, Sisson, D., primary, Alghamedi, A., primary, Shargall, Y., primary, Greenberg, B., primary, Huynh, C., primary, Al Rawahi, A., primary, Humer, M., primary, Le Nguyen, D., primary, Kaafarani, M., primary, Hunka, N., primary, Churchill, I., primary, Finley, C., primary, Jones, D., primary, Gupta, V., primary, Peters, E., primary, Robinson, M., primary, Wang, H., primary, Graham, K., primary, Bruinooge, A., primary, Verhoeff, K., primary, Cahill, C., primary, Hajjar, R., primary, Purich, K., primary, Garfinkle, R., primary, Talwar, G., primary, AlSulaim, H., primary, Brissette, V., primary, Holland, J., primary, Brown, C., primary, Li, M., primary, Monton, O., primary, AlAamer, O., primary, Ruxton, R., primary, Motamedi, M.K., primary, Caminsky, N., primary, Bayat, Z., primary, Liang, J., primary, Roy, H., primary, Moon, J., primary, Salama, E., primary, Wiseman, V., primary, Harra, Z., primary, Hegagi, M., primary, Alghaithi, N., primary, Papillon, E., primary, Kasteel, N., primary, Szwimer, R., primary, Merchant, S., primary, Li, V., primary, Jacobson, M., primary, Marini, W., primary, DiPasquale, A., primary, Gagnon, N., primary, Mysuria), S., primary, Hunter-Smith, A., primary, Alqaydi, A., primary, Di Lena, É., primary, Mysuria, S., primary, Kapur, H., primary, Cadili, L., primary, Ng, D., primary, Allen, K., primary, Cyr, D., primary, Allard-Coutu, A., primary, Mardinger, C., primary, Nguyen, D., primary, Langer, S., primary, Lim, D., primary, Reyna-Sepulveda, F., primary, Hanna, N., primary, Henault, D., primary, Lemke, M., primary, Lund, M., primary, Park, L., primary, Glinka, J., primary, Waugh, E., primary, Webb, A., primary, Essaji, Y., primary, Shrader, H., primary, Smith, V., primary, Gilbert, R., primary, Mir, Z., primary, Elbekri, S., primary, Zuker, N., primary, Chartrand, G., primary, Melland-Smith, M., primary, McLean, C., primary, Fortin, M., primary, Keshavjee, S., primary, Deaninck, F., primary, Cloutier, Z., primary, Shiroky, J., primary, Jarrar, A., primary, Lin, W., primary, Connell, M., primary, Vergis, A., additional, Unger, B., additional, Park, J., additional, Gillman, L., additional, Pace, D., additional, Lam-Tin-Cheung, K., additional, Chadi, S., additional, Quereshy, F., additional, Catton, J., additional, Rubin, B., additional, Bell, J., additional, Marangos, J., additional, Heesters, A., additional, Stuart-McEwan, T., additional, Wright, F., additional, Ahmed, N., additional, Nadler, A., additional, Hallet, J., additional, Chen, L., additional, Hwang, H., additional, Hirpara, D., additional, Sidhu, R., additional, Scott, T., additional, Karimuddin, A., additional, Nguyen, A., additional, Osborn, J., additional, Wiseman, S., additional, Nabata, K., additional, Baker, L., additional, Park, L., additional, Vered, M., additional, Zahrai, A., additional, Shorr, R., additional, Davis, A., additional, McIsaac, D., additional, Tinmouth, A., additional, Fergusson, D., additional, Martel, G., additional, Rummel, S., additional, Stefic-Cubic, M., additional, Stewart, M., additional, Melck, A., additional, Anpalagan, T., additional, Ichhpuniani, S., additional, Lee, Y., additional, Ramji, K., additional, Eskicioglu, C., additional, Deng, S., additional, Greene, B., additional, Tsang, M., additional, Palter, V., additional, Jayaraman, S., additional, Mann, A., additional, Tittley, J., additional, Cadeddu, M., additional, Madani, A., additional, Pasternak, J., additional, Hong, D., additional, Istl, A., additional, Tang, E., additional, Gray, D., additional, Coburn, N., additional, Callum, J., additional, McLeod, R., additional, Pearsall, E., additional, Lin, Y., additional, Turgeon, A., additional, Mahar, A., additional, Kriviraltcheva-Kaneva, P., additional, Lee, L., additional, Cools-Lartigue, J., additional, Ferri, L., additional, Mueller, C., additional, Haas, B., additional, Tillman, B., additional, Guttman, M., additional, Chesney, T., additional, Zuk, V., additional, Hsu, A., additional, Chan, W., additional, Vasdev, R., additional, Huynh, C., additional, Ling, L. Cadili J., additional, Warburton, R., additional, Hameed, M., additional, Williamson, H., additional, Murphy, P., additional, Leslie, K., additional, Hawel, J., additional, Zablotny, S., additional, Roldan, H., additional, Jiang, X., additional, Zheng, B., additional, Fiore, J., additional, Feldman, L., additional, Fried, G., additional, Valanci, S., additional, Cipolla, J., additional, Kaneva, P., additional, Demyttenaere, S., additional, Boutros, M., additional, Alhashemi, M., additional, Purich, K., additional, Verhoeff, K., additional, Shapiro, J., additional, Bigam, D., additional, Kung, J., additional, Mosko, J., additional, Hamilton, P., additional, Ghosh, S., additional, Widder, S., additional, Schiller, D., additional, El Kefraoui, C., additional, Pook, M., additional, Barone, N., additional, Balvardi, S., additional, Montgomery, H., additional, Nguyen-Powanda, P., additional, Rajabiyazdi, F., additional, Elhaj, H., additional, Lapointe-Gagner, M., additional, Olleik, G., additional, Antoun, A., additional, Safa, N., additional, Di Lena, E., additional, Meterissian, S., additional, Meguerditchian, A., additional, Lee, F., additional, Baldini, G., additional, Parpia, S., additional, Ruo, L., additional, Tywonek, K., additional, Lee, S., additional, O’Neill, C., additional, Faisal, N., additional, Alfayyadh, A., additional, Gundayao, M., additional, Meyers, B.M., additional, Habashi, R., additional, McKechnie, T., additional, Levin, M., additional, Aldrich, K., additional, Grantcharov, T., additional, Langerman, A., additional, Anantha, R., additional, Fawcett, V., additional, Hetherington, A., additional, Gervais, M., additional, Rakovich, G., additional, Hu, R., additional, Musselman, R., additional, Raiche, I., additional, Moloo, H., additional, Elnahas, A., additional, Alkhamesi, N., additional, Alnumay, A., additional, Schlachta, C., additional, Zhang, C., additional, Cristancho, S., additional, Ott, M., additional, Niu, B., additional, Balaa, F., additional, Gawad, N., additional, Qiu, Y., additional, Hamann, K., additional, How, N., additional, Leveille, C., additional, Davidson, A., additional, Eqbal, A., additional, Sardiwalla, Y., additional, Korostensky, M., additional, Lee, E., additional, Yang, I., additional, Ren, K., additional, Stukel, T., additional, de Mestral, C., additional, Nathens, A., additional, Karanicolas, P., additional, Lemieux, S., additional, Breton, D., additional, Bouchard, P., additional, Bouchard, A., additional, Grégoire, R., additional, Letarte, F., additional, Bouchard, G., additional, Drolet, S., additional, Avoine, S., additional, Gagné, J., additional, Thibault, C., additional, Jutras Bouthillette, N., additional, Gosselin, M., additional, Stuleanu, T., additional, Jarrar, A., additional, Kolozsvari, N., additional, Nenshi, R., additional, Jerath, A., additional, Gomez, D., additional, Amir, T., additional, Liu, E., additional, Farquharson, S., additional, Mao, R., additional, Lan, L., additional, Yan, J., additional, Allard-Coutu, A., additional, Tin, R., additional, Brisebois, R., additional, Bradley, N., additional, Walser, E., additional, Hartford, L., additional, Van Koughnett, J., additional, Vogt, K., additional, Hilsden, R., additional, Parry, N., additional, Allen, L., additional, Jones, J., additional, Neumann, K., additional, Strickland, M., additional, O’Dochartaigh, D., additional, Lobay, K., additional, Kabaroff, A., additional, Chang, E., additional, Beck, J., additional, Davidson, J., additional, Jones, S., additional, Van Hooren, T., additional, El Hafid, M., additional, Dang, J., additional, Mocanu, V., additional, Lutzak, G., additional, Sultanian, R., additional, Wong, C., additional, Karmali, S., additional, Petrera, M., additional, Pickell, M., additional, Auer, R., additional, Li, B., additional, Sun, W., additional, Jogiat, U., additional, Switzer, N., additional, Al Hinai, A., additional, Cieply, A., additional, Hawes, H., additional, Joos, E., additional, Saleh, A., additional, Engels, P., additional, Kwong, M., additional, Ellsmere, J., additional, Chang, D., additional, Hutter, M., additional, Spence, R., additional, Vasilevsky, C., additional, Morin, N., additional, Longtin, Y., additional, Liberman, S., additional, Montpetit, P., additional, Poirier, M., additional, Mukherjee, K., additional, Sebajang, H., additional, Younan, R., additional, Schwenter, F., additional, De Broux, E., additional, Skelhorne-Gross, G., additional, Beckett, A., additional, Nantais, J., additional, Kay, J., additional, Lohre, R., additional, Ayeni, O., additional, Goel, D., additional, de SA, D., additional, Hylton, D., additional, Bedard, E., additional, Johnson, S., additional, Laing, B., additional, Valji, A., additional, Hanna, W., additional, Turner, S., additional, Akhtar-Danesh, N., additional, Shargall, Y., additional, Gupta, V., additional, Kidane, B., additional, Limbachia, J., additional, Farrokhyar, F., additional, Leontiadis, G., additional, Patel, Y., additional, Churchill, I., additional, Xie, F., additional, Seely, A., additional, Spicer, J., additional, Yasufuku, K., additional, Sullivan, K., additional, Beauchamp, M., additional, Wald, J., additional, Mbuagbaw, L., additional, Agzarian, J., additional, Finley, C., additional, Fahim, C., additional, Olaiya, O., additional, Begum, H., additional, Palma, D., additional, Warner, A., additional, Malthaner, R., additional, Fortin, D., additional, Qiabi, M., additional, Nayak, R., additional, Nguyen, T., additional, Louie, A., additional, Rodrigues, G., additional, Yaremko, B., additional, Laba, J., additional, Inculet, R., additional, Mador, B., additional, Lai, H., additional, White, J., additional, Kim, M., additional, Darling, G., additional, Rousseau, M., additional, Samarasinghe, Y., additional, Lee, M., additional, Thiru, L., additional, Levine, O., additional, Juergens, R., additional, Brogly, S., additional, Li, W., additional, Lougheed, D., additional, Petsikas, D., additional, Gatti, A., additional, Anestee, C., additional, Gilbert, S., additional, Sundaresan, S., additional, Villeneuve, P., additional, Maziak, D., additional, Ashrafi, A., additional, Tregobov, N., additional, Hassanzadeh, N., additional, Stone, S., additional, Panjwani, A., additional, Bong, T., additional, Bond, R., additional, Hafizi, A., additional, Rayes, R., additional, Milette, S., additional, Vagai, M., additional, Usatii, M., additional, Chandrasekaran, A., additional, Giannias, B., additional, Bourdeau, F., additional, Sangwan, V., additional, Bertos, N., additional, Moraes, C., additional, Huang, S., additional, Quail, D., additional, Walsh, L., additional, Camilleri-Broet, S., additional, Fiset, P., additional, Bilgic, E., additional, Quaiattini, A., additional, Maurice-Ventouris, M., additional, Najmeh, S., additional, Lu, J., additional, Malhan, R., additional, Brennan, K., additional, French, D., additional, Momtazi, M., additional, Solaja, O., additional, Donahoe, L., additional, Bedard, P., additional, Hansen, A., additional, De Perrot, M., additional, Simone, A., additional, Huang, J., additional, Murthy, S., additional, Lin, J., additional, Li, H., additional, Crowther, M., additional, Linkins, L., additional, Lau, E., additional, Schneider, L., additional, Douketis, J., additional, Allen-Avodabo, C., additional, Davis, L., additional, Zhao, H., additional, Sirois, C., additional, Mulder, D., additional, Aftab Abdul, S., additional, Nguyen, D., additional, Anstee, C., additional, Delic, E., additional, Sasewich, H., additional, Islam, T., additional, Low, D., additional, Al Rawahi, A., additional, Kay, M., additional, Shayegan, B., additional, Adili, A., additional, Chouiali, F., additional, Muthukrishnan, N., additional, Maleki, F., additional, Ovens, K., additional, Gold, M., additional, Sorin, M., additional, Falutz, R., additional, Forghani, R., additional, Kennedy, R., additional, Bigsby, R., additional, Bharadwaj, S., additional, Gowing, S., additional, Pearce, K., additional, Kumar, S., additional, Gingrich, M., additional, Ahmadzai, Z., additional, Thavorn, K., additional, Namavarian, A., additional, Mohammed, A., additional, Uddin, S., additional, Jones, D., additional, Behzadi, A., additional, Brar, A., additional, Buduhan, G., additional, Tan, L., additional, Liu, R., additional, Srinathan, S., additional, Levy, J., additional, Ringash, J., additional, Sutradhar, R., additional, Bednarek, L., additional, MacDonald, D., additional, Enns, S., additional, Tan, A., additional, Poole, E., additional, Pascoe, C., additional, Karakach, T., additional, Halayko, A., additional, Fang, B., additional, Birch, D., additional, Singh, H., additional, Hershorn, O., additional, Hochman, D., additional, Helewa, R., additional, Robertson, R., additional, Lipson, M., additional, Afzal, A., additional, Maclean, A., additional, Roen, S., additional, Buie, W., additional, Chu, M., additional, Amin, N., 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Ghuman, A., additional, Muncner, S., additional, Mihajlovic, I., additional, Dykstra, M., additional, Snelgrove, R., additional, Wang, H., additional, Smith, A., additional, AlSelaim, N., additional, AlMalki, M., additional, Al-osail, A., additional, Manuel, P., additional, Mohamed, F., additional, Serahati, S., additional, Rajendran, L., additional, Brown, C., additional, Phang, T., additional, Alavi, K., additional, Paquette, I., additional, MacLean, T., additional, Wexner, S., additional, Steele, S., additional, Patel, S., additional, Bordeianou, L., additional, Sylla, P., additional, Kennedy, E., additional, Victor, C., additional, Govindarajan, A., additional, Baig, Z., additional, Karimmudin, A., additional, Gill, D., additional, Ginther, N., additional, Alrashid, F., additional, Zhang, L., additional, MacDonald, P., additional, Merchant, S.M., additional, Wattie Barnett, K., additional, Caycedo-Marulanda, A., additional, Patel, S.V., additional, Kaur, G., additional, Bindra, S., additional, Malhotra, A., additional, Graham, C., additional, MacLean, A., additional, Beck, P., additional, Jijon, H., additional, Ferraz, J., additional, Kong, W., additional, Gyawali, B., additional, Hanna, T., additional, Chung, W., additional, Nanji, S., additional, Booth, C., additional, Awan, A., additional, Serrano, P., additional, Chanco, M., additional, Wen, V., additional, Singh, N., additional, Peiris, L., additional, Pasieka, J., additional, Ghatage, P., additional, Buie, D., additional, Bouchard-Fortier, A., additional, Mack, L., additional, Zheng, W., additional, Swallow, C., additional, Reedijk, M., additional, Prus-Czrnecka, Z., additional, Delmar, L., additional, Villiard, R., additional, Martel, É., additional, Cadrin-Chênevert, A., additional, Ledoux, É., additional, Racicot, C., additional, Bazzarelli, A., additional, Pao, J., additional, Zhang, M., additional, McKevitt, E., additional, Kuusk, U., additional, Van Laeken, N., additional, Bovill, E., additional, Isaac, K., additional, Dingee, C., additional, Cuthbert, C., additional, Fergus, K., additional, Barbera, L., additional, Efegoma, Y., additional, Howell, D., additional, Isherwood, S., additional, Levasseur, N., additional, Scheer, A., additional, Simmons, C., additional, Srikantham, A., additional, Temple-Orberle, C., additional, Xu, Y., additional, Metcalfe, K., additional, Quan, M., additional, la, J., additional, Merchant, S., additional, Digby, G., additional, Brind’Amour, A., additional, Sidéris, L., additional, Dubé, P., additional, De Guerke, L., additional, Fortin, S., additional, Auclair, M., additional, Trilling, B., additional, Tremblay, J., additional, Hopkins), B., additional, Wong, S., additional, Hopkins, B., additional, Dumitra, S., additional, Bazarelli, A., additional, DeGirolamo, K., additional, Ali, A., additional, Eymae, D., additional, Lee, K., additional, Brar, S., additional, Conner, J., additional, Magalhaes, M., additional, Baliski, C., additional, Sari, A., additional, Messenger, D., additional, Driman, D., additional, Assarzadegan, N., additional, Juda, A., additional, Brar, M., additional, Kirsch, R., additional, Singh, K., additional, Lamontagne, A., additional, Gamache, Y., additional, Lee, C., additional, Duckworth, R., additional, Brindle, M., additional, Fraulin, F., additional, Austen, L., additional, Kortbeek, J., additional, Hyndman, M., additional, Jamjoum, G., additional, Yuan Xu, Y., additional, Kong, S., additional, Retrouvey, H., additional, Kerrebijn, I., additional, Butler, K., additional, O’Neill, A., additional, Cil, T., additional, Zhong, T., additional, Hofer, S., additional, McCready, D., additional, Look Hong, N., additional, Skipworth, J., additional, Mah, A., additional, Desai, S., additional, Chung, S., additional, Scudamore, C., additional, Segedi, M., additional, Vasilyeva, E., additional, Li, J., additional, Kim, P., additional, Deprato, A., additional, Dajani, K., additional, Gilbert, R., additional, Smoot, R., additional, Tzeng, C., additional, Rocha, F., additional, Yohanathan, L., additional, Cleary, S., additional, Bertens, K., additional, Badrudin, D., additional, Gala-Lopez, B., additional, Wei, X., additional, Kaliwal, Y., additional, Wei, A., additional, Barrette, B., additional, Pelletier, S., additional, Thebault, P., additional, Beaudry-Simoneau, E., additional, Rong, Z., additional, Plasse, M., additional, Dagenais, A. Roy M., additional, Létourneau, R., additional, Lapointe, R., additional, Vandenbroucke-Menu, F., additional, Nguyen, B., additional, Soucy, G., additional, Turcotte, S., additional, Waugh, E., additional, Quan, D., additional, Skaro, A., additional, Glinka, J., additional, Jada, G., additional, Daza, J., additional, Li, V., additional, Msallak, H., additional, Zhang, B., additional, Workneh, A., additional, Faisal, S., additional, Faisal, R., additional, Fabbro, M., additional, Gu, C., additional, Claassen, M., additional, Sapisochin, G., additional, Lemke, M., additional, Breadner, D., additional, Welch, S., additional, Lester, E., additional, Shapiro, A., additional, Eurich, D., additional, Nayyar, A., additional, Suraju, M., additional, Williams-Perez, S., additional, Ear, P., additional, Chan, C., additional, Rivers-Bowerman, M., additional, Costa, A., additional, Stueck, A., additional, Campbell, N., additional, Allen, S., additional, Lenet, T., additional, Golding, H., additional, McKeown, S., additional, Flemming, J., additional, Groome, P., additional, Djerboua, M., additional, Girard, E., additional, Morency-Potvin, P., additional, Dagenais, M., additional, Roy, A., additional, Letourneau, R., additional, Simoneau, E., additional, Oakley, M., additional, Misheva, B., additional, Bendavid, Y., additional, Smith, L., additional, Tan, J., additional, Kahn, U., additional, Paré, X., additional, Doyon, A., additional, Schwenger, K., additional, Yadav, J., additional, Fischer, S., additional, Jackson, T., additional, Allard, J., additional, Okrainec, A., additional, Anvari, S., additional, Lovrics, O., additional, Aditya, I., additional, Khondker, A., additional, Walsh, M., additional, Hardy, K., additional, Romanescu, R., additional, Linton, J., additional, Fowler-Woods, M., additional, Fowler-Woods, A., additional, Shingoose, G., additional, Zmudzinski, M., additional, Archer, V., additional, Abu Halimah, J., additional, Boudreau, V., additional, Marcil, G., additional, Mierzwa, A., additional, Hardy-Henry, A., additional, and Hagen, J., additional

Published
2021
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12. Safety of Surgical Lung Biopsy for Diagnosis of Interstitial Lung Diseases

Author

Yoo, D., primary, Wongkarnjana, A., additional, Agzarian, J., additional, Shargall, Y., additional, Finley, C., additional, Hanna, W., additional, Ayoub, A., additional, Aziz-ur-Rehman, A., additional, Cox, G.P., additional, Scallan, C.J., additional, Ask, K., additional, Kolb, M.R.J., additional, and Hambly, N., additional

Published
2021
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14. MA07.04 Breathe Anew: Designing and Testing the Feasibility of a Novel Intervention for Lung Cancer Survivorship

Author

Patel, Y., primary, Churchill, I., additional, Sullivan, K., additional, Beauchamp, M., additional, Wald, J., additional, Mbuagbaw, L., additional, Key, B., additional, Green, S., additional, Bieling, P., additional, Agzarian, J., additional, Finley, C., additional, Shargall, Y., additional, Fahim, C., additional, and Hanna, W., additional

Published
2021
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18. OA01.02 Endobronchial Ultrasound Staging of Operable NSCLC: Triple Negative Lymph Nodes May Not Require Routine Biopsy

Author

Hylton, D., primary, Selvakumaran, K., additional, Kidane, B., additional, Spicer, J., additional, Turner, S., additional, French, D., additional, Wen, C., additional, Masters, J., additional, Patel, Y., additional, Taylor, J., additional, Finley, C., additional, Shargall, Y., additional, Farrokhyar, F., additional, Agzarian, J., additional, Seely, A., additional, Yasufuku, K., additional, and Hanna, W., additional

Published
2019
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19. ENDOBRONCHIAL ULTRASOUND STAGING OF OPERABLE NSCLC: TRIPLE NEGATIVE LYMPH NODES MAY NOT REQUIRE ROUTINE BIOPSY

Author

Hylton, D., primary, Selvakumaran, K., additional, Kidane, B., additional, Spicer, J., additional, Turner, S., additional, French, D., additional, Wen, C., additional, Masters, J., additional, Finley, C., additional, Shargall, Y., additional, Farrokhyar, F., additional, Agzarian, J., additional, Seely, A., additional, Yasufuku, K., additional, and Hanna, W.C., additional

Published
2019
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22. MA13.05 The Canada Lymph Node Sonographic Score: National Validation of a Sonographic Score to Determine Mediastinal Lymph Node Malignancy

Author

Hylton, D., primary, Huang, J., additional, Turner, S., additional, French, D., additional, Wen, C., additional, Masters, J., additional, Kidane, B., additional, Spicer, J., additional, Taylor, J., additional, Finley, C., additional, Shargall, Y., additional, Fahim, C., additional, Farrokhyar, F., additional, Yasufuku, K., additional, Agzarian, J., additional, and Hanna, W., additional

Published
2018
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24. Canadian Surgery Forum1 Is laparoscopic sleeve gastrectomy a reasonable stand-alone procedure for super morbidly obese patients?2 Postoperative monitoring requirements of patients with obstructive sleep apnea undergoing bariatric surgery3 Role of relaparoscopy in the diagnosis and treatment of bariatric complications in the early postoperative period4 Changes of active and total ghrelin, GLP-1 and PYY following restrictive bariatric surgery and their impact on satiety: comparison of sleeve gastrectomy and adjustable gastric banding5 Prioritization and willingness to pay for bariatric surgery: the patient perspective6 Ventral hernia at the time of laparoscopic gastric bypass surgery: Should it be repaired?7 Linear stapled gastrojejunostomy with transverse handsewn enterotomy closure significantly reduces strictures for laparoscopic Roux-en-Y bypass8 Laparoscopic biliopancreatic diversion with duodenal switch as second stage for super super morbidly obese patients. Do all patients benefit?9 Sleeve gastrectomy in the super super morbidly obese (BMI > 60 kg/m2): a Canadian experience10 Laparoscopic gastric bypass for the treatment of refractory idiopathic gastroparesis: a report of 2 cases11 Duodeno-ileal switch as a primary bariatric and metabolic surgical option for the severely obese patient with comorbidities: review of a single-institution case series of duodeno-ileal intestinal bypass12 Management of large paraesophageal hernias in morbidly obese patients with laparoscopic sleeve gastrectomy: a case series13 Early results of the Ontario bariatric surgical program: using the bariatric registry14 Improving access to bariatric surgical care: Is universal health care the answer?15 Early and liberal postoperative exploration can reduce morbidity and mortality in patients undergoing bariatric surgery16 Withdrawn17 Identification and assessment of technical errors in laparoscopic Roux-en-Y gastric bypass18 A valid and reliable tool for assessment of surgical skill in laparoscopic Roux-en-Y gastric bypass19 Psychiatric predictors of presurgery drop-out following suitability assessment for bariatric surgery20 Predictors of outcomes following Roux-en-Y gastric bypass surgery at The Ottawa Hospital21 Prophylactic management of cholelithiasis in bariatric patients: Is routine cholecystectomy warranted?22 Early outcomes of Roux-en-Y gastric bypass in a publicly funded obesity program23 Similar incidence of gastrojejunal anastomotic stricture formation with hand-sewn and 21 mm circular stapler techniques during Roux-en-Y gastric bypass24 (CAGS Basic Science Award) Exogenous glucagon-like peptide-1 improves clinical, morphological and histological outcomes of intestinal adaptation in a distal-intestinal resection piglet model of short bowel syndrome25 (CAGS Clinical Research Award) Development and validation of a comprehensive curriculum to teach an advanced minimally invasive procedure: a randomized controlled trial26 Negative-pressure wound therapy (iVAC) on closed, high-risk incisions following abdominal wall reconstruction27 The impact of seed granting on research in the University of British Columbia Department of Surgery28 Quality of surgical care is inadequate for elderly patients29 Recurrence of inguinal hernia in general and hernia specialty hospitals in Ontario, Canada30 Oncostatin M receptor deficiency results in increased mortality in an intestinal ischemia reperfusion model in mice31 Laparoscopic repair of large paraesophageal hernias with anterior gastropexy: a multicentre trial32 Response to preoperative medical therapy predicts success of laparoscopic splenectomy for immune thrombocytopenic purpura33 Perioperative sepsis, but not hemorrhagic shock, promotes the development of cancer metastases in a murine model34 Measuring the impact of implementing an acute care surgery service on the management of acute biliary disease35 Patient flow and efficiency in an acute care surgery service36 The relationship between treatment factors and postoperative complications after radical surgery for rectal cancer37 Risk of ventral hernia after laparoscopic colon surgery38 Urinary metabolomics as a tool for early detection of Barrett’s and esophageal cancer39 Construct validity of individual and summary performance metrics associated with a computer-based laparo-scopic simulator40 Impact of a city-wide health system reorganization on emergency department visits in hospitals in surrounding communities41 Transcatheter aortic valve implantation for the nonoperative management of aortic stenosis: a cost-effectiveness analysis42 Breast cancer: racial differences in age of onset. A potential confounder in Canadian screening recommendations43 Risk taking in surgery: in and out of the comfort zone44 A tumour board in the office: Track those cancer patients!45 Increased patient BMI is not associated with advanced colon cancer stage or grade on presentation: a retrospective chart review46 Consensus statements regarding the multidisciplinary care of limb amputation patients in disasters or humanitarian emergencies. Report of the 2011 Humanitarian Action Summit Surgical Working Group on amputations following disasters or conflict47 Learning the CanMEDS role of professional: a pilot project of supervised discussion groups addressing the hidden curriculum48 Assessing the changing scope of training in Canadian general surgery programs: expected versus actual experience49 Predicting need for surgical management for massive gastrointestinal hemorrhage50 International health care experience: using CanMEDS to evaluate learning outcomes following a surgical mission in Mampong, Ghana51 The open abdomen: risk factors for mortality and rates of closure52 How surgeons think: an exploration of mental practice in surgical preparation53 The surgery wiki: a novel method for delivery of under-graduate surgical education54 Understanding surgical residents’ postoperative practices before implementing an enhanced recovery after surgery (ERAS) guideline at the University of Toronto55 From laparoscopic transabdominal to posterior retroperitoneal adrenalectomy: a paradigm shift in operative approach56 A retrospective audit of outcomes in patients over the age of 80 undergoing acute care abdominal surgery57 Canadian general surgery residents’ perspectives on work-hour regulations58 Timing of surgical intervention and its outcomes in acute appendicitis59 Preparing surgical trainees to deal with adverse events. An outline of learning issues60 Acute care surgical service: surgeon agreement at the time of handover61 Predicting discharge of elderly patients to prehospitalization residence following emergency general surgery62 Morbidity and mortality after emergency abdominal surgery in octo- and nonagenarians63 The impact of acute abdominal illness and urgent admission to hospital on the living situation of elderly patients64 A comparison of laparoscopic versus open subtotal gastrectomy for antral gastric adenocarcinoma: a North American perspective65 Minimally invasive excision of ectopic mediastinal parathyroid adenomas66 Perioperative outcomes of laparoscopic hernia repair in a tertiary care centre: a single institution’s experience67 Evaluation of a student-run, practical and didactic curriculum for preclerkship medical students68 Joseph Lister: Father of Modern Surgery69 Comparisons of melanoma sentinel lymph node biopsy prediction nomograms in a cohort of Canadian patients70 Local experience with myocutaneous flaps after extensive pelvic surgery71 The treatment of noncirrhotic splanchnic vein thrombosis: Is anticoagulation enough?72 Implementation of an acute care surgery service does not affect wait-times for elective cancer surgeries: an institutional experience73 Use of human collagen mesh for closure of a large abdominal wall defect, after colon cancer surgery, a case report74 The role of miR-200b in pulmonary hypoplasia associated with congenital diaphragmatic hernia75 Systematic review and meta-analysis of electrocautery versus scalpel for incising epidermis and dermis76 Accuracy of sentinel lymph node biopsy for early breast cancer in the community setting in St. John’s, New-foundland: results of a retrospective review77 Acute surgical outcomes in the 80 plus population78 The liberal use of platelets transfusions in the acute phase of trauma resuscitation: a systematic review79 Implementation of an acute care surgical on call program in a Canadian community hospital80 Short-term outcomes following paraesophageal hernia repair in the elderly patient81 First experience with single incision surgery: feasibility in the pediatric population and cost evaluation82 The impact of the establishment of an acute care surgery unit on the outcomes of appendectomies and cholecystectomies83 Description and preliminary evaluation of a low-cost simulator for training and evaluation of flexible endoscopic skills84 Tumour lysis syndrome in metastatic colon cancer: a case report85 Acute care surgery service model implementation study at a single institution86 Colonic disasters approached by emergent subtotal and total colectomy: lessons learned from 120 consecutive cases87 Acellular collagen matrix stent to protect bowel anastomoses88 Lessons we learned from preoperative MRI-guided wire localization of breast lesions: the University Health Network (UHN) experience89 Interim cost comparison for the use of platinum micro-coils in the operative localization of small peripheral lung nodules90 Routine barium esophagram has minimal impact on the postoperative management of patients undergoing esophagectomy for esophageal cancer91 Iron deficiency anemia is a common presenting issue with giant paraesophageal hernia and resolves following repair92 A randomized comparison of different ventilation strategies during thoracotomy and lung resection93 The Canadian Lung Volume Reduction Surgery study: an 8-year follow-up94 A comparison of minimally invasive versus open Ivor-Lewis esophagectomy95 A new paradigm in the follow-up after curative resection for lung cancer: minimal-dose CT scan allows for early detection of asymptomatic cancer activity96 Predictors of lymph node metastasis in early esophageal adenocarcinoma: Is endoscopic resection worth the risk?97 How well can thoracic surgery residents operate? Comparing resident and program director opinions98 The impact of extremes of age on short- and long-term outcomes following surgical resection of esophageal malignancy99 Epidermal growth factor receptor targeted gold nanoparticles for the enhanced radiation treatment of non–small cell lung cancer100 Laparoscopic Heller myotomy results in excellent outcomes in all subtypes of achalasia as defined by the Chicago classification101 Neoadjuvant chemoradiation versus surgery in managing esophageal cancer102 Quality of life postesophagectomy for cancer!103 The implementation, evolution and translocation of standardized clinical pathways can improve perioperative outcomes following surgical treatment of esophageal cancer104 A tissue-mimicking phantom for applications in thoracic surgical simulation105 Sublobar resection compared with lobectomy for early stage non–small cell lung cancer: a single institution study106 Not all reviews are equal: the quality of systematic reviews and meta-analyses in thoracic surgery107 Do postoperative complications affect health-related quality of life after video-assisted thoracoscopic lobectomy for patients with lung cancer? A cohort study108 Thoracoscopic plication for palliation of dyspnea secondary to unilateral diaphragmatic paralysis: A worthwhile venture?109 Thoracic surgery experience in Canadian general surgery residency programs110 Perioperative morbidity and pathologic response rates following neoadjuvant chemotherapy and chemoradiation for locally advanced esophageal carcinoma111 An enhanced recovery pathway reduces length of stay after esophagectomy112 Predictors of dysplastic and neoplastic progression of Barrett’s esophagus113 Recurrent esophageal cancer complicated by tracheoesophageal fistula: management by means of palliative airway stenting114 Pancreaticopleural fistula-induced empyema thoracis: principles and results of surgical management115 Prognostic factors of early postoperative mortality following right extended hepatectomy116 Optimizing steatotic livers for transplantation using a cell-penetrating peptide CPP-fused heme oxygenase117 Video outlining the technical steps for a robot-assisted laparoscopic pancreaticoduodenectomy118 Establishment of a collaborative group to conduct innovative clinical trials in Canada119 Hepatic resection for metastatic malignant melanoma: a systematic review and meta-analysis120 Acellular normothermic ex vivo liver perfusion for donor liver preservation121 Pancreatic cancer and predictors of survival: comparing the CA 19–9/bilirubin ratio with the McGill Brisbane Scoring System122 Staged liver resections for bilobar hepatic colorectal metastases: a single centre experience123 Economic model of observation versus immediate resection of hepatic adenomas124 Resection of colorectal liver metastasis in the elderly125 Acceptable long-term survival in patients undergoing liver resection for metastases from noncolorectal, non-neuroendocrine, nonsarcoma malignancies126 Patient and clinicopathological features and prognosis of CK19+ hepatocellular carcinomas: a case–control study127 The management of blunt hepatic trauma in the age of angioembolization: a single centre experience128 Liver resections for noncolorectal and non-neuroendocrine metastases: an evaluation of oncologic outcomes129 Developing an evidence-based clinical pathway for patients undergoing pancreaticoduodenectomy130 Hepatitis C infection and hepatocellular carcinoma in liver transplant: a 20 year experience131 The effect of medication on the risk of post-ERCP pancreatitis132 Temporal trends in the use of diagnostic imaging for patients with hepato-pancreato-biliary (HPB) conditions: How much ionizing radiation are we really using?196 A phase II study of aggressive metastasectomy for intra-and extrahepatic metastases from colorectal cancer133 Why do women choose mastectomy for breast cancer treatment? A conceptual framework for understanding surgical decision-making in early-stage breast cancer134 Synoptic operative reporting: documentation of quality of care data for rectal cancer surgery135 Learning curve analysis for cytoreductive surgery: a useful application of the cumulative sum (CUSUM) method136 Pancreatic cancer is strongly associated with a unique urinary metabolomic signature137 Concurrent neoadjuvant chemo/radiation in locally advanced breast cancer138 Impact of positron emission tomography on clinical staging of newly diagnosed rectal cancer: a specialized single centre retrospective study139 An evaluation of intraoperative Faxitron microradiography versus conventional specimen radiography for the excision of nonpalpable breast lesions140 Comparison of breast cancer treatment wait-times in the Southern Interior of British Columbia in 2006 and 2010141 Factors affecting lymph nodes harvest in colorectal carcinoma142 Laparoscopic adrenalectomy for metastases143 You have a message! Social networking as a motivator for fundamentals of laparoscopic surgery (FLS) training144 The evaluation and validation of a rapid diagnostic and support clinic for women assessment for breast cancer145 Oncoplastic breast surgery: oncologic benefits and limitations146 A qualitative study on rectal cancer patients’ preferences for location of surgical care147 The effect of surgery on local recurrence in young women with breast cancer148 Elevated IL-6 and IL-8 levels in tumour microenvironment is not associated with increased serum levels in humans with Pseudomyxoma peritonei and peritoneal mesothelioma149 Conversion from laparoscopic to open approach during gastrectomy: a population-based analysis150 A scoping review of surgical process improvement tools (SPITs) in cancer surgery151 Splenectomy during gastric cancer surgery: a population-based study152 Defining the polo-like kinase 4 (Plk4) interactome in cancer cell protrusions153 Neoadjuvant imatinib mesylate for locally advanced gastrointestinal stromal tumours154 Implementing results from ACOSOG Z0011: Practice-changing or practice-affirming?155 Should lymph node retrieval be a surgical quality indicator in colon cancer?156 Long-term outcomes following resection of retroperitoneal recurrence of colorectal cancer157 Clinical research in surgical oncology: an analysis of clinicaltrials.gov158 Radiation therapy after breast conserving surgery: When are we missing the mark?159 The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery160 Quality improvement in gastrointestinal cancer surgery: expert panel recommendations for priority research areas161 Factors influencing the quality of local management of ductal carcinoma in situ: a cohort study162 Papillary thyroid microcarcinoma: Does size matter?163 Hyperthermic isolated limb perfusion for extremity soft tissue sarcomas: systematic review of clinical efficacy and quality assessment of reported trials164 Adherence to antiestrogen therapy in seniors with breast cancer: How well are we doing?165 Parathyroid carcinoma: Challenging the surgical dogma?166 A qualitative assessment of the journey to delayed breast reconstruction195 The role of yoga therapy in breast cancer patients167 Outcomes reported in comparative studies of surgical interventions168 Enhanced recovery pathways decrease length of stay following colorectal surgery, but how quickly do patients actually recover?169 The impact of complications on bed utilization after elective colorectal resection170 Impact of trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study171 Complex fistula-in-ano: Should the plug be abandoned in favour of the LIFT or BioLIFT?172 Prognostic utility of cyclooxygenase-2 expression by colon and rectal cancer173 Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is complex and time-consuming: analysis of learning curves for a novice minimally invasive surgeon174 Intraoperative quality assessment following double stapled circular colorectal anastomosis175 Improving patient outcomes through quality assessment of rectal cancer care176 Are physicians willing to accept a decrease in treatment effectiveness for improved functional outcomes for low rectal cancer?177 Turnbull-Cutait delayed coloanal anastomosis for the treatment of distal rectal cancer: a prospective cohort study178 Preoperative high-dose rate brachytherapy in preparation for sphincter preservation surgery for patients with advanced cancer of the lower rectum179 Impact of an enhanced recovery program on short-term outcomes after scheduled laparoscopic colon resection180 The clinical results of the Turnbull-Cutait delayed coloanal anastomosis: a systematic review181 Is a vertical rectus abdominus flap (VRAM) necessary? An analysis of perineal wound complications182 Fistula plug versus endorectal anal advancement flap for the treatment of high transsphincteric cryptoglandular anal fistulas: a systematic review and meta-analysis183 Maternal and neonatal outcomes following colorectal cancer surgery184 Transanal drainage to treat anastomotic leaks after low anterior resection for rectal cancer: a valuable option185 Trends in colon cancer in Ontario: 2002–2009186 Validation of electronically derived short-term outcomes in colorectal surgery187 A population-based assessment of transanal and endoscopic resection for adenocarcinoma of the rectum188 Laparoscopic colorectal surgery in the emergency setting: trends in the province of Ontario from 2002 to 2009189 Prevention of perineal hernia after laparoscopic and robotic abdominoperineal resection: review with case series of internal hernia through pelvic mesh which was placed in attempt to prevent perineal hernia190 Effect of rectal cancer treatments on quality of life191 The use of antibacterial sutures as an adjunctive preventative strategy for surgical site infection in Canada: an economic analysis192 Impact of socioeconomic status on colorectal cancer screening and stage at presentation: preliminary results of a population-based study from an urban Canadian centre193 Initial perioperative results of the first transanal endoscopic microsurgery (TEM) program in the province of Quebec194 Use of negative pressure wound therapy decreases perineal wound infections following abdominal perineal resection

Author

Fayez, R., primary, AlMuntashery, A., primary, Bodie, G., primary, Almamar, A., primary, Gill, R.S., primary, Raîche, I., primary, Mueller, C.L., primary, Moustarah, F., primary, Khokhotva, M., primary, Anvari, M., primary, Kwong, J., primary, Elkassem, S., primary, Bonrath, E., primary, Zevin, B., primary, Sockalingam, S., primary, Smith, C., primary, Whitlock, K.A., primary, Suri, M., primary, Palter, V.N., primary, Wakeam, E., primary, Khan, R.S.A., primary, Martelli, V., primary, Malik, A., primary, Young, P.Y., primary, Daigle, C., primary, McCreery, G., primary, Seth, R., primary, Paskar, D., primary, Sudarshan, M., primary, Richardson, D., primary, Haggar, F., primary, Davis, V.W., primary, Rivard, J., primary, Agzarian, J., primary, Racz, J., primary, Winocour, J., primary, Zilbert, N.R., primary, Decker, C., primary, Neumann, K., primary, Gosney, J.E., primary, Wissanji, H., primary, Chadi, S.A., primary, Alhabboubi, M., primary, Partridge, E., primary, Olszewski, M., primary, Chan, R., primary, Nadler, A., primary, Hameed, U., primary, Brotherhood, H., primary, Menezes, A.S., primary, MacDonald, B., primary, Rakovich, G., primary, Hilsden, R., primary, Merani, S., primary, Davis, P., primary, Davis, P.J.B., primary, Cools-Lartigue, J., primary, Ojah, J., primary, Julien, F., primary, Carter, D., primary, Pitt, D., primary, Banks, B.A., primary, Rudovics, A., primary, Ravichandran, P., primary, Anantha, R., primary, Aad, I., primary, Kholdebarin, R., primary, Aird, L.N.F., primary, Wong, S.L., primary, Payne, J.R.M., primary, Hallet, J., primary, Farries, L., primary, Raiche, I., primary, Botkin, C., primary, Morency, D., primary, Berger-Richardson, D., primary, Isa, A.D., primary, Dupuis, I, primary, Schweigert, M., primary, Koubi, S., primary, Ernjakovic, M., primary, Grant, K., primary, Carrott, P., primary, Stafford, T., primary, Malthaner, R., primary, Hanna, W.C., primary, Lee, L., primary, Markar, S., primary, Razzak, R., primary, Bharadwaj, S.C., primary, Ashrafi, A.S., primary, Ouellette, D., primary, Bottoni, D.A., primary, Knickle, C., primary, Coughlin, S., primary, Gazala, S., primary, Donahoe, L., primary, Walker, K., primary, Li, C., primary, Alnasser, S., primary, Zhuruk, A., primary, Hanouf, A., primary, Vanounou, T., primary, Karanicolas, P., primary, Aubin, J.-M., primary, Yeung, J.C., primary, Dumitra, S., primary, Simoneau, E., primary, Vanounou, T.T., primary, Howe, B., primary, Hawel, J., primary, Jang, J.-H., primary, Bertens, K., primary, Rekman, J.F., primary, Wei, A.C., primary, Ouellet, J.-F., primary, Covelli, A., primary, Maniar, R., primary, Sun, S., primary, Brackstone, M., primary, Boissonneault, R., primary, Kim, S.H.H., primary, Baliski, C., primary, Arnaout, A., primary, Wedman, D., primary, Nostedt, M., primary, Hebbard, P., primary, Shetty, S.J., primary, Dixon, M., primary, Kazazian, K., primary, Lemke, M., primary, Wells, B., primary, Musselman, R.P., primary, Zih, F. Si Wai, primary, Nassif, M., primary, Leon-Carlyle, M., primary, Krotneva, S., primary, Bradley, N.L., primary, Trabulsi, N., primary, Chin-Lenn, L., primary, Cheng, H., primary, Petrucci, A.M., primary, Sandhu, L., primary, Neville, A., primary, Yang, I., primary, Prabhu, K. Lobo, primary, Melich, G., primary, Knowles, S., primary, Borowiec, A.M., primary, Kolozsvari, N.O., primary, Tuttle, P., primary, VanHouwelingen, L., primary, Boulanger-Gobeil, C., primary, Chan, B.P., primary, Phang, P.T., primary, Goldstein, L.J., primary, Wen, C., primary, Lebrun, A., primary, Roy, M., additional, Villeneuve, S., additional, AlMuntashery, A., additional, Demyttenaere, S., additional, Christou, N., additional, Court, O., additional, Fayez, R., additional, Bonrath, E., additional, Hagen, J., additional, Okrainec, A., additional, Sullivan, P., additional, Grantcharov, T., additional, Sharma, A., additional, Karmali, S., additional, Birch, D.W., additional, Majumdar, S.R., additional, Wang, X., additional, Tuepah, R., additional, Klarenbach, S.W., additional, Sharma, A.M., additional, Padwal, R.J., additional, Smith, C., additional, Haggar, F., additional, Moloo, H., additional, Poulin, E.C., additional, Martel, G., additional, Yelle, J.-D., additional, Mamazza, J., 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Published
2012
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26. Errors in Pneumotachography with Intermittent Positive Pressure Ventilation

Author

Abrahams, N., Fisk, G. C., Churches, A. E., Loughman, J., Vonwiller, J. B., Agzarian, J., and Harrison, G. A.

Abstract

Instrument errors that can occur when pneumotachography is used during Intermittent Positive Pressure Ventilation (IPPV) have been described previously (Kafer 1973). Our efforts to eliminate these errors led to the discovery of further inaccuracies, which appear to be due to the design of the differential pressure transducers used with the pneumotachograph head. A system was used in which a sine-wave pump delivered a constant tidal volume to a dummy lung, the tidal volume being measured by means of a pneumotachograph. Using Grass, Statham and Devices differential pressure transducers, the volume recorded as leaving the dummy lung was consistently greater than that recorded as entering, and changing the pneumatic polarity of the differential pressure transducer produced large differences in the recorded volume. In some cases the error was greater than the volume being measured. There would seem to be several causes of such errors. The Sanborn 270 differential pressure transducer and the Greer micromanometer appeared to be free of these artifacts.The results of this study throw into doubt much previously published work using pneumotachography during IPPV.

Published
1975
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31. 2023 Canadian Surgery Forum: Sept. 20-23, 2023.

Author

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Wong C, Hakim SY, Azizi S, El-Menyar A, Rizoli S, Al-Thani H, Fernandes AR, French D, Li C, Ellsmere J, Gossen S, French D, Bailey J, Tibbo P, Crocker C, Bondzi-Simpson A, Ribeiro T, Kidane B, Ko M, Coburn N, Kulkarni G, Hallet J, Ramzee AF, Afifi I, Alani M, El-Menyar A, Rizoli S, Al-Thani H, Chughtai T, Huo B, Manos D, Xu Z, Kontouli KM, Chun S, Fris J, Wallace AMR, French DG, Giffin C, Liberman M, Dayan G, Laliberté AS, Yasufuku K, Farivar A, Kidane B, Weessies C, Robinson M, Bednarek L, Buduhan G, Liu R, Tan L, Srinathan SK, Kidane B, Nasralla A, Safieddine N, Gazala S, Simone C, Ahmadi N, Hilzenrat R, Blitz M, Deen S, Humer M, Jugnauth A, Buduhan G, Kerr L, Sun S, Browne I, Patel Y, Hanna W, Loshusan B, Shamsil A, Naish MD, Qiabi M, Nayak R, Patel R, Malthaner R, Pooja P, Roberto R, Greg H, Daniel F, Huynh C, Sharma S, Vieira A, Jain F, Lee Y, Mousa-Doust D, Costa J, Mezei M, Chapman K, Briemberg H, Jack K, Grant K, Choi J, Yee J, McGuire AL, Abdul SA, Khazoom F, Aw K, Lau R, Gilbert S, Sundaresan S, Jones D, Seely AJE, Villeneuve PJ, Maziak DE, Pigeon CA, Frigault J, Drolet S, Roy ÈM, Bujold-Pitre K, Courval V, Tessier L, McKechnie T, Lee Y, Park L, Gangam N, Eskicioglu C, Cloutier Z, McKechnie T (McMaster University), Archer V, Park L, Lee J, Patel A, Hong D, Eskicioglu C, Ichhpuniani S, McKechnie T, Elder G, Chen A, Logie K, Doumouras A, Hong D, Benko R, Eskicioglu C, Castelo M, Paszat L, Hansen B, Scheer A, Faught N, Nguyen L, Baxter N, Sharma S, McKechnie T, Khamar J, Wu K, Eskicioglu C, McKechnie T, Khamar J, Lee Y, Tessier L, Passos E, Doumouras A, Hong D, Eskicioglu C, McKechnie T, Khamar J, Sachdeva A, Lee Y, Hong D, Eskicioglu C, Fei LYN, Caycedo A, Patel S, Popa T, Boudreau L, Grin A, Wang T, Lie J, Karimuddin A, Brown C, Phang T, Raval M, Ghuman A, Candy S, Nanda K, Li C, Snelgrove R, Dykstra M, Kroeker K, Wang H, Roy H, Helewa RM, Johnson G, Singh H, Hyun E, Moffatt D, Vergis A, Balmes P, Phang T, Guo M, Liu J, Roy H, Webber S, Shariff F, Helewa RM, Hochman D, Park J, Johnson G, Hyun E, Robitaille S, Wang A, Maalouf M, Alali N, Elhaj H, Liberman S, Charlebois P, Stein B, Feldman L, Fiore JF Jr, Lee L, Hu R, Lacaille-Ranger A, Ahn S, Tudorache M, Moloo H, Williams L, Raîche I, Musselman R, Lemke M, Allen L, Samarasinghe N, Vogt K, Brackstone M, Zwiep T, Clement E, Lange C, Alam A, Ghuman A, Karimuddin A, Phang T, Raval M, Brown C, Clement E, Liu J, Ghuman A, Karimuddin A, Phang T, Raval M, Brown C, Mughal HN, Gok MA, Khan UA, Mughal HN, Gok MA, Khan UA, Mughal HN, Gok MA, Khan UA, Mughal HN, Gok MA, Khan UA, James N, Zwiep T, Van Koughnett JA, Laczko D, McKechnie T, Yang S, Wu K, Sharma S, Lee Y, Park L, Doumouras A, Hong D, Parpia S, Bhandari M, Eskicioglu C, McKechnie T, Tessier L, Lee S, Kazi T, Sritharan P, Lee Y, Doumouras A, Hong D, Eskicioglu C, McKechnie T, Lee Y, Hong D, Dionne J, Doumouras A, Parpia S, Bhandari M, Eskicioglu C, Hershorn O, Ghuman A, Karimuddin A, Brown C, Raval M, Phang PT, Chen A, Boutros M, Caminsky N, Dumitra T, Faris-Sabboobeh S, Demian M, Rigas G, Monton O, Smith A, Moon J, Demian M, Garfinkle R, Vasilevsky CA, Rajabiyazdi F, Boutros M, Courage E, LeBlanc D, Benesch M, Hickey K, Hartwig K, Armstrong C, Engelbrecht R, Fagan M, Borgaonkar M, Pace D, Shanahan J, Moon J, Salama E, Wang A, Arsenault M, Leon N, Loiselle C, Rajabiyazdi F, Boutros M, Brennan K, Rai M, Farooq A, McClintock C, Kong W, Patel S, Boukhili N, Caminsky N, Faris-Sabboobeh S, Demian M, Boutros M, Paradis T, Robitaille S, Dumitra T, Liberman AS, Charlebois P, Stein B, Fiore JF Jr, Feldman LS, Lee L, Zwiep T, Abner D, Alam T, Beyer E, Evans M, Hill M, Johnston D, Lohnes K, Menard S, Pitcher N, Sair K, Smith B, Yarjau B, LeBlanc K, Samarasinghe N, Karimuddin AA, Brown CJ, Phang PT, Raval MJ, MacDonell K, Ghuman A, Harvey A, Phang PT, Karimuddin A, Brown CJ, Raval MJ, Ghuman A, Hershorn O, Ghuman A, Karimuddin A, Raval M, Phang PT, Brown C, Logie K, Mckechnie T, Lee Y, Hong D, Eskicioglu C, Matta M, Baker L, Hopkins J, Rochon R, Buie D, MacLean A, Ghuman A, Park J, Karimuddin AA, Phang PT, Raval MJ, Brown CJ, Farooq A, Ghuman A, Patel S, Macdonald H, Karimuddin A, Raval M, Phang PT, Brown C, Wiseman V, Brennan K, Patel S, Farooq A, Merchant S, Kong W, McClintock C, Booth C, Hann T, Ricci A, Patel S, Brennan K, Wiseman V, McClintock C, Kong W, Farooq A, Kakkar R, Hershorn O, Raval M, Phang PT, Karimuddin A, Ghuman A, Brown C, Wiseman V, Farooq A, Patel S, Hajjar R, Gonzalez E, Fragoso G, Oliero M, Alaoui AA, Rendos HV, Djediai S, Cuisiniere T, Laplante P, Gerkins C, Ajayi AS, Diop K, Taleb N, Thérien S, Schampaert F, Alratrout H, Dagbert F, Loungnarath R, Sebajang H, Schwenter F, Wassef R, Ratelle R, Debroux É, Cailhier JF, Routy B, Annabi B, Brereton NJB, Richard C, Santos MM, Gimon T, MacRae H, de Buck van Overstraeten A, Brar M, Chadi S, Kennedy E, Baker L, Hopkins J, Rochon R, Buie D, MacLean A, Park LJ, Archer V, McKechnie T, Lee Y, McIsaac D, Rashanov P, Eskicioglu C, Moloo H, Devereaux PJ, Alsayari R, McKechnie T, Ichhpuniani S, Lee Y, Eskicioglu C, Hajjar R, Oliero M, Fragoso G, Ajayi AS, Alaoui AA, Rendos HV, Calvé A, Cuisinière T, Gerkins C, Thérien S, Taleb N, Dagbert F, Sebajang H, Loungnarath R, Schwenter F, Ratelle R, Wassef R, Debroux E, Richard C, Santos MM, Kennedy E, Simunovic M, Schmocker S, Brown C, MacLean A, Liberman S, Drolet S, Neumann K, Stotland P, Jhaveri K, Kirsch R, Alnajem H, Alibrahim H, Giundi C, Chen A, Rigas G, Munir H, Safar A, Sabboobeh S, Holland J, Boutros M, Kennedy E, Richard C, Simunovic M, Schmocker S, Brown C, MacLean A, Liberman S, Drolet S, Neumann K, Stotland P, Jhaveri K, Kirsch R, Bruyninx G, Gill D, Alsayari R, McKechnie T, Lee Y, Hong D, Eskicioglu C, Zhang L, Abtahi S, Chhor A, Best G, Raîche I, Musselman R, Williams L, Moloo H, Caminsky NG, Moon JJ, Marinescu D, Pang A, Vasilevsky CA, Boutros M, Al-Abri M, Gee E, Karimuddin A, Phang PT, Brown C, Raval M, Ghuman A, Morena N, Ben-Zvi L, Hayman V, Hou M (University of Calgary), Nguyen D, Rentschler CA, Meguerditchian AN, Mir Z, Fei L, McKeown S, Dinchong R, Cofie N, Dalgarno N, Cheifetz R, Merchant S, Jaffer A, Cullinane C, Feeney G, Jalali A, Merrigan A, Baban C, Buckley J, Tormey S, Benesch M, Wu R, Takabe K, Benesch M, O'Brien S, Kazazian K, Abdalaty AH, Brezden C, Burkes R, Chen E, Govindarajan A, Jang R, Kennedy E, Lukovic J, Mesci A, Quereshy F, Swallow C, Chadi S, Habashi R, Pasternak J, Marini W, Zheng W, Murakami K, Ohashi P, Reedijk M, Hu R, Ivankovic V, Han L, Gresham L, Mallick R, Auer R, Ribeiro T, Bondzi-Simpson A, Coburn N, Hallet J, Cil T, Fontebasso A, Lee A, Bernard-Bedard E, Wong B, Li H, Grose E, Brandts-Longtin O, Aw K, Lau R, Abed A, Stevenson J, Sheikh R, Chen R, Johnson-Obaseki S, Nessim C, Hennessey RL, Meneghetti AT, Bildersheim M, Bouchard-Fortier A, Nelson G, Mack L, Ghasemi F, Naeini MM, Parsyan A, Kaur Y, Covelli A, Quereshy F, Elimova E, Panov E, Lukovic J, Brierley J, Burnett B, Swallow C, Eom A, Kirkwood D, Hodgson N, Doumouras A, Bogach J, Whelan T, Levine M, Parvez E, Ng D, Kazazian K, Lee K, Lu YQ, Kim DK, Magalhaes M, Grigor E, Arnaout A, Zhang J, Yee EK, Hallet J, Look Hong NJ, Nguyen L, Coburn N, Wright FC, Gandhi S, Jerzak KJ, Eisen A, Roberts A, Ben Lustig D, Quan ML, Phan T, Bouchard-Fortier A, Cao J, Bayley C, Watanabe A, Yao S, Prisman E, Groot G, Mitmaker E, Walker R, Wu J, Pasternak J, Lai CK, Eskander A, Wasserman J, Mercier F, Roth K, Gill S, Villamil C, Goldstein D, Munro V, Pathak A (University of Manitoba), Lee D, Nguyen A, Wiseman S, Rajendran L, Claasen M, Ivanics T, Selzner N, McGilvray I, Cattral M, Ghanekar A, Moulton CA, Reichman T, Shwaartz C, Metser U, Burkes R, Winter E, Gallinger S, Sapisochin G, Glinka J, Waugh E, Leslie K, Skaro A, Tang E, Glinka J, Charbonneau J, Brind'Amour A, Turgeon AF, O'Connor S, Couture T, Wang Y, Yoshino O, Driedger M, Beckman M, Vrochides D, Martinie J, Alabduljabbar A, Aali M, Lightfoot C, Gala-Lopez B, Labelle M, D'Aragon F, Collin Y, Hirpara D, Irish J, Rashid M, Martin T, Zhu A, McKnight L, Hunter A, Jayaraman S, Wei A, Coburn N, Wright F, Mallette K, Elnahas A, Alkhamesi N, Schlachta C, Hawel J, Tang E, Punnen S, Zhong J, Yang Y, Streith L, Yu J, Chung S, Kim P, Chartier-Plante S, Segedi M, Bleszynski M, White M, Tsang ME, Jayaraman S, Lam-Tin-Cheung K, Jayaraman S, Tsang M, Greene B, Pouramin P, Allen S, Evan Nelson D, Walsh M, Côté J, Rebolledo R, Borie M, Menaouar A, Landry C, Plasse M, Létourneau R, Dagenais M, Rong Z, Roy A, Beaudry-Simoneau E, Vandenbroucke-Menu F, Lapointe R, Ferraro P, Sarkissian S, Noiseux N, Turcotte S, Haddad Y, Bernard A, Lafortune C, Brassard N, Roy A, Perreault C, Mayer G, Marcinkiewicz M, Mbikay M, Chrétien M, Turcotte S, Waugh E, Sinclair L, Glinka J, Shin E, Engelage C, Tang E, Skaro A, Muaddi H, Flemming J, Hansen B, Dawson L, O'Kane G, Feld J, Sapisochin G, Zhu A, Jayaraman S, Cleary S, Hamel A, Pigeon CA, Marcoux C, Ngo TP, Deshaies I, Mansouri S, Amhis N, Léveillé M, Lawson C, Achard C, Ilkow C, Collin Y, Tai LH, Park L, Griffiths C, D'Souza D, Rodriguez F, McKechnie T, Serrano PE, Hennessey RL, Yang Y, Meneghetti AT, Panton ONM, Chiu CJ, Henao O, Netto FS, Mainprize M, Hennessey RL, Chiu CJ, Hennessey RL, Chiu CJ, Jatana S, Verhoeff K, Mocanu V, Jogiat U, Birch D, Karmali S, Switzer N, Hetherington A, Verhoeff K, Mocanu V, Birch D, Karmali S, Switzer N, Safar A, Al-Ghaithi N, Vourtzoumis P, Demyttenaere S, Court O, Andalib A, Wilson H, Verhoeff K, Dang J, Kung J, Switzer N, Birch D, Madsen K, Karmali S, Mocanu V, Wu T, He W, Vergis A, Hardy K, Zmudzinski M, Daenick F, Linton J, Zmudzinski M, Fowler-Woods M, He W, Fowler-Woods A, Shingoose G, Vergis A, Hardy K, Lee Y, Doumouras A, Molnar A, Nguyen F, Hong D, Schneider R, Fecso AB, Sharma P, Maeda A, Jackson T, Okrainec A, McLean C, Mocanu V, Birch D, Karmali S, Switzer N, MacVicar S, Dang J, Mocanu V, Verhoeff K, Jogiat U, Karmali S, Birch D, Switzer N, McLennan S, Verhoeff K, Purich K, Dang J, Kung J, Mocanu V, McLennan S, Verhoeff K, Mocanu V, Jogiat U, Birch DW, Karmali S, Switzer NJ, Jeffery L, Hwang H, Ryley A, Schellenberg M, Owattanapanich N, Emigh B, Nichols C, Dilday J, Ugarte C, Onogawa A, Matsushima K, Martin MJ, Inaba K, Schellenberg M, Emigh B, Nichols C, Dilday J, Ugarte C, Onogawa A, Shapiro D, Im D, Inaba K, Schellenberg M, Owattanapanich N, Ugarte C, Lam L, Martin MJ, Inaba K, Rezende-Neto J, Patel S, Zhang L, Mir Z, Lemke M, Leeper W, Allen L, Walser E, Vogt K, Ribeiro T, Bateni S, Bondzi-Simpson A, Coburn N, Hallet J, Barabash V, Barr A, Chan W, Hakim SY, El-Menyar A, Rizoli S, Al-Thani H, Mughal HN, Bhugio M, Gok MA, Khan UA, Warraich A, Gillman L, Ziesmann M, Momic J, Yassin N, Kim M, Makish A, Walser E, Smith S, Ball I, Moffat B, Parry N, Vogt K, Lee A, Kroeker J, Evans D, Fansia N, Notik C, Wong EG, Coyle G, Seben D, Smith J, Tanenbaum B, Freedman C, Nathens A, Fowler R, Patel P, Elrick T, Ewing M, Di Marco S, Razek T, Grushka J, Wong EG, Park LJ, Borges FK, Nenshi R, Serrano PE, Engels P, Vogt K, Di Sante E, Vincent J, Tsiplova K, Devereaux PJ, Talwar G, Dionne J, McKechnie T, Lee Y, Kazi T, El-Sayes A, Bogach J, Hong D, Eskicioglu C, Connell M, Klooster A, Beck J, Verhoeff K, Strickland M, Anantha R, Groszman L, Caminsky NG, Watt L, Boulanger N, Razek T, Grushka J, Di Marco S, Wong EG, Livergant R, McDonald B, Binda C, Luthra S, Ebert N, Falk R, and Joos E

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2023
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32. Gastrojejunostomy versus endoscopic stenting for the palliation of malignant gastric outlet obstruction: a systematic review and meta-analysis.

Author

Khamar J, Lee Y, Sachdeva A, Anpalagan T, McKechnie T, Eskicioglu C, Agzarian J, Doumouras A, and Hong D

Subjects
Adult, Humans, Female, Aged, Male, Palliative Care methods, Endoscopy adverse effects, Stents adverse effects, Retrospective Studies, Gastric Bypass methods, Gastric Outlet Obstruction etiology, Gastric Outlet Obstruction surgery
Abstract

Background: Though gastrojejunostomy (GJ) has been a standard palliative procedure for gastric outlet obstruction (GOO), endoscopic stenting (ES) has shown to provide benefits due to its non-invasive approach. The aim of this review is to perform a comprehensive evaluation of ES versus GJ for the palliation of malignant GOO., Methods: MEDLINE, Embase, and CENTRAL databases were searched and comparative studies of adult GOO patients undergoing ES or GJ were eligible for inclusion. The primary outcomes were survival time and mortality. Secondary outcomes included technical success, clinical success, reinterventions, days until oral food tolerance, postoperative adjuvant palliative chemotherapy, postoperative morbidities, length of stay (LOS), and costs. Pairwise meta-analyses using inverse-variance random effects were performed., Results: After identifying 2222 citations, 39 full-text articles fit the inclusion criteria. In total, 3128 ES patients (41.4% female, age: 68.0 years) and 2116 GJ patients (40.4% female, age: 66.8 years) were included. ES patients experienced a shorter survival time (mean difference -24.77 days, 95% Cl - 45.11 to  - 4.43, p = 0.02) and were less likely to undergo adjuvant palliative chemotherapy (risk ratio 0.81, 95% Cl 0.70 to 0.93, p = 0.004). The ES group had a shorter LOS, shorter time to oral intake of liquids and solids, and less surgical site infections (risk ratio 0.30, 95% Cl 0.12 to 0.75, p = 0.01). The patients in the ES group were at greater risk of requiring reintervention (risk ratio 2.60, 95% Cl 1.87 to 3.63, p < 0.001)., Conclusion: ES results in less postoperative morbidity and shorter LOS when compared to GJ, however, this may be at the cost of decreased initiation of adjuvant palliative chemotherapy and overall survival, as well as increased risk of reintervention. Both techniques are likely appropriate in select clinical scenarios., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2023
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33. The short and long-term effects of open vs minimally invasive thymectomy in myasthenia gravis patients: a systematic review and meta-analysis.

Author

Lee Y, Samarasinghe Y, Patel J, Khondker A, McKechnie T, Samarasinghe N, Finley C, Hanna W, Shargall Y, and Agzarian J

Subjects
Humans, Remission Induction, Length of Stay, Minimally Invasive Surgical Procedures, Treatment Outcome, Retrospective Studies, Thymectomy methods, Myasthenia Gravis surgery, Myasthenia Gravis etiology
Abstract

Objective: Thymectomy has been utilized as a treatment for Myasthenia Gravis (MG) for many decades, with both open and minimally invasive surgical (MIS) techniques currently used. Although MIS has shown improved short-term results, long-term effects remain uncertain. This systematic review and meta-analysis aim to compare the post-operative and long-term outcomes of MIS versus open thymectomy in MG patients., Methods: MEDLINE, EMBASE and CENTRAL databases were searched from inception till January 2022 for keywords related to MG and open or MIS thymectomy. Primary outcome was complete stable remission (CSR), and secondary outcomes were clinical improvement, complications, length of stay, operation time, and blood loss. Grading of recommendations, assessment, development, and evaluation was used to assess the certainty of evidence., Results: 26 studies with 3588 patients were included in the analysis. At 1, 3 and 5 years, there was no statistical difference noted in CSR between open versus MIS thymectomy. However, CSR was improved at 1 year for MIS thymectomy in non-thymomatous MG (P = 0.03). There was no significant difference in rates of partial clinical improvement between techniques at 1-year. Although analyses on length of hospital stay and blood loss showed improvement following MIS thymectomy, operative time was shorter for open thymectomy., Conclusion: This is the first systematic review and meta-analysis assessing long-term effects of MIS versus open thymectomy in MG patients. Given the lack of significant differences noted, either MIS or open thymectomy can be performed, based on surgeon preference. Further high-level, long-term research should be conducted to determine the benefit of each technique., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2023
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34. Comparison of ventilation defects quantified by Technegas SPECT and hyperpolarized 129 Xe MRI.

Author

Radadia N, Friedlander Y, Priel E, Konyer NB, Huang C, Jamal M, Farncombe T, Marriott C, Finley C, Agzarian J, Dolovich M, Noseworthy MD, Nair P, Shargall Y, and Svenningsen S

Abstract

Introduction: The ideal contrast agents for ventilation SPECT and MRI are Technegas and 129 Xe gas, respectively. Despite increasing interest in the clinical utility of ventilation imaging, these modalities have not been directly compared. Therefore, our objective was to compare the ventilation defect percent (VDP) assessed by Technegas SPECT and hyperpolarized 129 Xe MRI in patients scheduled to undergo lung cancer resection with and without pre-existing obstructive lung disease. Methods: Forty-one adults scheduled to undergo lung cancer resection performed same-day Technegas SPECT, hyperpolarized 129 Xe MRI, spirometry, and diffusing capacity of the lung for carbon monoxide (DL CO ). Ventilation abnormalities were quantified as the VDP using two different methods: adaptive thresholding (VDP T ) and k-means clustering (VDP K ). Correlation and agreement between VDP quantified by Technegas SPECT and 129 Xe MRI were determined by Spearman correlation and Bland-Altman analysis, respectively. Results: VDP measured by Technegas SPECT and 129 Xe MRI were correlated (VDP T : r = 0.48, p = 0.001; VDP K : r = 0.63, p < 0.0001). A 2.0% and 1.6% bias towards higher Technegas SPECT VDP was measured using the adaptive threshold method (VDP T : 23.0% ± 14.0% vs. 21.0% ± 5.2%, p = 0.81) and k-means method (VDP K : 9.4% ± 9.4% vs. 7.8% ± 10.0%, p = 0.02), respectively. For both modalities, higher VDP was correlated with lower FEV 1 /FVC (SPECT VDP T : r = -0.38, p = 0.01; MRI VDP K : r = -0.46, p = 0.002) and DL CO (SPECT VDP T : r = -0.61, p < 0.0001; MRI VDP K : r = -0.68, p < 0.0001). Subgroup analysis revealed that VDP measured by both modalities was significantly higher for participants with COPD (n = 13) than those with asthma (n = 6; SPECT VDP T : p = 0.007, MRI VDP K : p = 0.006) and those with no history of obstructive lung disease (n = 21; SPECT VDP T : p = 0.0003, MRI VDP K : p = 0.0003). Discussion: The burden of ventilation defects quantified by Technegas SPECT and 129 Xe MRI VDP was correlated and greater in participants with COPD when compared to those without. Our observations indicate that, despite substantial differences between the imaging modalities, quantitative assessment of ventilation defects by Technegas SPECT and 129 Xe MRI is comparable., Competing Interests: The authors declare that this was an investigator-initiated study that received funding from Cyclomedica Australia Pty Ltd. and The Lung Association. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication. SS reports a relationship with Polarean that includes: Speaking and lecture fees. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Radadia, Friedlander, Priel, Konyer, Huang, Jamal, Farncombe, Marriott, Finley, Agzarian, Dolovich, Noseworthy, Nair, Shargall and Svenningsen.)

Published
2023
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35. The fragility of significant results from randomized controlled trials in esophageal surgeries.

Author

Lee Y, Samarasinghe Y, Javidan A, Tahir U, Samarasinghe N, Shargall Y, Finley C, Hanna W, and Agzarian J

Subjects
Humans, Randomized Controlled Trials as Topic, Sample Size, Esophagectomy adverse effects
Abstract

While randomized controlled trials (RCTs) are regarded as one of the highest forms of clinical research, the robustness of their P values can be difficult to ascertain. Defined as the minimum number of patients in a study arm that would need to be changed from a non-event to event for the findings to lose significance, the Fragility Index is a method for evaluating results from these trials. This study aims to calculate the Fragility Index for trials evaluating perioperative esophagectomy-related interventions to determine the strength of RCTs in this field. MEDLINE and EMBASE were searched for RCTs related to esophagectomy that reported a significant dichotomous outcome. Two reviewers independently screened articles and performed the data extractions with risk of bias assessment. The Fragility Index was calculated using a two-tailed Fisher's exact test. Bivariate correlation was conducted to evaluate associations between the Fragility Index and study characteristics. 41 RCTs were included, and the median sample size was 80 patients [Interquartile range (IQR) 60-161]. Of the included outcomes, 29 (71%) were primary, and 12 (29%) were secondary. The median Fragility Index was 1 (IQR 1-3), meaning that by changing one patient from a non-event to event, the results would become non-significant. Fragility Index was correlated with P value, number of events, and journal impact factor. The RCTs related to esophagectomy did not prove to be robust, as the significance of their results could be changed by altering the outcome status of a handful of patients in one study arm., (© 2023. Crown.)

Published
2023
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36. Can a mobile app technology reduce emergency department visits and readmissions after lung resection? A prospective cohort study.

Author

Minervini F, Taylor J, Hanna WC, Agzarian J, Hughes K, Pinkney P, Lopez-Hernandez Y, Coret M, Schneider L, Finley C, Rushton J, Tran A, and Shargall Y

Subjects
Humans, Patient Discharge, Aftercare, Prospective Studies, Emergency Service, Hospital, Cohort Studies, Technology, Lung, Patient Readmission, Mobile Applications
Abstract

Background: Emergency department (ED) visits and readmissions after thoracic surgery are a major health care problem. We hypothesized that the addition of a novel post-discharge mobile app specific to thoracic surgery to an existing home care program would reduce ED visits and readmissions compared to a home care program alone., Methods: We conducted a prospective cohort study of patients undergoing major lung resection for malignant disease between November 2016 and May 2018. Patients received either home care alone (control group) or home care plus a patient-input mobile app (intervention group). Primary outcomes were 30-day readmission and ED visit rates. Secondary outcomes included reasons for ED visits and readmissions, perioperative complications, 30-day mortality, anxiety (assessed with the Generalized Anxiety Disorder-7 Scale [GAD-7]) and app-related adverse events. We compared outcomes between the 2 groups, analyzing the data on an intention-to-treat basis., Results: Despite the greater number of open surgery and anatomic resections in the intervention cohort, patients in that group were less likely than those in the control group to visit the ED within 30 days of discharge (24.0% v. 38.8%, p = 0.02). Thirty-day readmission rates were similar between the intervention and control groups (10.1% v. 12.2%, p = 0.6). In a subset of patients, there was no difference between the 2 groups in the proportion of patients with a GAD-7 score of 0 (control group 79.8%, intervention group 79.5%, p = NS), which indicated a similar absence of postdischarge anxiety and depression symptoms in the 2 cohorts., Conclusion: The addition of a mobile app to a home care program after thoracic surgery was associated with a reduced frequency of ED visits, in spite of the higher proportions of thoracotomies and anatomic resections in the app cohort. More studies are needed to evaluate the full effect of this new, emerging technology., Competing Interests: Competing interests: Waël Hanna reports a grant from Intuitive Surgical, consulting fees from Minogue Medical, and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Minogue Medical and AstraZeneca. He participates on an advisory board for Roche Genentech. He holds stock or stock options in Intuitive Surgical. No other competing interests were declared., (© 2022 CMA Impact Inc. or its licensors.)

Published
2022
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37. The role of brachytherapy in treatment of stage I esophageal cancer: A systematic review.

Author

Choe SI, Lee Y, Habashi R, Samarasinghe Y, Lee MH, McKechnie T, Shargall Y, Finley C, Hanna W, Sur R, and Agzarian J

Subjects
Humans, Retrospective Studies, Radiotherapy Dosage, Brachytherapy methods, Esophageal Neoplasms radiotherapy, Esophageal Squamous Cell Carcinoma
Abstract

Purpose: Despite advancements in the early detection of esophageal cancer, optimal radiotherapy methods for treatment of early disease have not yet been determined. Moreover, the benefit of intraluminal brachytherapy on local control or survival remains controversial. We performed a systematic review to establish the role of brachytherapy as boost therapy in stage I esophageal squamous cell carcinoma, and to evaluate associated survival outcomes., Methods and Materials: A systematic search of three bibliographic databases from January 1950 to January 2019 was conducted. All studies investigating brachytherapy for curative intent were included and palliative treatment was excluded. Primary outcomes included overall survival and disease-free survival (DFS). Secondary outcomes included loco-regional control (LRC) and toxicity grades and/or complications. Two reviewers independently abstracted data and evaluated study quality using grading of recommendations assessment, development, and evaluation, pooled results were presented through risk ratios., Results: A total of 12 retrospective studies met inclusion criteria. The overall quality of evidence yielded a Grade 1C rating (strong recommendation, low quality evidence). Of 525 included patients, 325 patients received both external beam radiation (EBRT), and brachytherapy, 132 underwent EBRT only, and 68 received brachytherapy with and/or without chemoradiation. For patient group treated with EBRT and brachytherapy, 5-year mortality, DFS and LRC were: 43% (27-59%), 63% (49-76%) and 72% (63-80%) respectively. Rates of complications reported included 82.1% Grade 1 esophagitis for a combined external beam radiation and brachytherapy cohort, 12.3% ulcerations, and 3.3% fistulae., Conclusions: Brachytherapy as a combined modality is encouraging, given its relative safety and effectiveness. Further prospective analysis using higher quality evidence is warranted to evaluate oncologic outcomes and survival advantage., (Copyright © 2022. Published by Elsevier Inc.)

Published
2022
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38. Robotic vs Thoracoscopic Anatomic Lung Resection in Obese Patients: A Propensity-Adjusted Analysis.

Author

Seder CW, Farrokhyar F, Nayak R, Baste JM, Patel Y, Agzarian J, Finley CJ, Shargall Y, Thomas PA, Dahan M, Verhoye JP, Mbadinga F, and Hanna WC

Subjects
Humans, Aged, Pneumonectomy, Postoperative Complications surgery, Thoracic Surgery, Video-Assisted, Thoracotomy, Obesity complications, Lung surgery, Retrospective Studies, Carcinoma, Non-Small-Cell Lung complications, Carcinoma, Non-Small-Cell Lung surgery, Robotic Surgical Procedures, Lung Neoplasms complications, Lung Neoplasms surgery
Abstract

Background: Minimally invasive lung resections can be particularly challenging in obese patients. We hypothesized robotic surgery (RTS) is associated with less conversion to thoracotomy than video-assisted thoracoscopic surgery (VATS) in obese populations., Methods: The Society of Thoracic Surgeons General Thoracic Surgery Database, Epithor French National Database, and McMaster University Thoracic Surgical Database were queried for obese (body mass index ≥30 kg/m 2 ) patients who underwent VATS or RTS lobectomy or segmentectomy for clinical T1-2, N0-1 non-small cell lung cancer between 2015 and 2019. Propensity score adjusted logistic regression analysis was used to compare the rate of conversion to thoracotomy between the VATS and RTS cohorts., Results: Overall, 8108 patients (The Society of Thoracic Surgeons General Thoracic Surgery Database: n = 7473; Epithor: n = 572; McMaster: n = 63) met inclusion criteria with a mean (SD) age of 66.6 (9) years and body mass index of 34.7 (4.5) kg/m 2 . After propensity score adjusted multivariable analysis, patients who underwent VATS were >5-times more likely to experience conversion to thoracotomy than those who underwent RTS (odds ratio, 5.33; 95% CI, 4.14-6.81; P < .001). There was a linear association between the degree of obesity and odds ratio of VATS conversion to thoracotomy compared with RTS. VATS patients had a longer mean length of stay (5.0 vs 4.3 days, P < .001), higher rate of respiratory failure (2.8% [168 of 5975] vs 1.8% [39 of 2133], P = .026), and were less likely to be discharged to their home (92.5% [5525 of 5975] vs 94.3% [2012 of 2133]; P = .013) compared with RTS patients., Conclusions: In obese patients, RTS anatomic lung resection is associated with a lower rate of conversion to thoracotomy than VATS., (Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

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2022
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39. Effect of routine jejunostomy tube insertion in esophagectomy: A systematic review and meta-analysis.

Author

Lee Y, Lu JY, Malhan R, Shargall Y, Finley C, Hanna W, and Agzarian J

Subjects
Anastomotic Leak etiology, Esophagectomy adverse effects, Humans, Length of Stay, Postoperative Complications etiology, Postoperative Complications therapy, Pneumonia, Sepsis complications
Abstract

Background: Routine feeding jejunostomy tube post esophagectomy is being revaluated because of its associated postoperative complications. We performed a systematic review and meta-analysis to evaluate the effect of routine feeding jejunostomy tube insertion on mortality and postesophagectomy outcomes., Methods: Electronic databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials) were queried through December 2020. Included studies compared esophagectomy with and without postoperative feeding jejunostomy. The primary outcome was 30-day mortality. Secondary outcomes included readmission rate, length of stay, postoperative complications (sepsis, pneumonia, chyle leakage, and anastomotic leakage), and duration of surgery. Random effects pairwise meta-analysis was used to compare groups, and the risk of bias was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool., Results: The meta-analyses of 12 studies (2 randomized controlled trials, 10 observational) that enrolled 36,284 participants showed lower 30-day all-cause mortality in the jejunostomy tube group (risk ratio [RR] = 1.53 [95% CI, 1.37-1.70], P < .01; I 2  = 0%, P = .80). Duration of surgery favored the no jejunostomy group (mean difference = -37.18; 95% CI, -59.48 to -14.87; P < .01). However, the 2 groups were not different in incidence of anastomotic leakage (RR = 0.88; 95% CI, 0.61-1.28; P = .50), length of stay (mean difference = -0.22; 95% CI, -1.34-0.89; P = .69), readmission (RR = 0.97; 95% CI, 0.92-1.02; P = .20), chyle leakage (RR = 1.05; 95% CI, 0.34-3.27; P = .94), sepsis (RR = 1.20; 95% CI, 0.96-1.50; P = .11), pneumonia (RR = 0.88; 95% CI, 0.75-1.03; P = .11)., Conclusions: Feeding jejunostomy tube after esophagectomy might lead to lower 30-day all-cause mortality with no difference in common postesophagectomy complications. A routine insertion of a jejunostomy tube should be considered at the time of surgery for esophageal cancer resection., (Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2022
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40. A risk model to predict an unplanned admission to the intensive care unit following lung resection.

Author

Brunelli A, Begum H, Chaudhuri N, Agzarian J, Milton R, Finley C, Tcherveniakov P, Valuckiene L, Gioutsos K, Hanna W, Papagiannopoulos K, and Shargall Y

Subjects
Hospitalization, Humans, Lung, Male, Retrospective Studies, Intensive Care Units, Pneumonectomy adverse effects, Pneumonectomy methods
Abstract

Objectives: The goal of this study was to develop a risk-adjusting model to stratify the risk of an unplanned admission to the intensive care unit (following lung resection)., Methods: We performed a retrospective analysis of 3123 patients undergoing anatomical lung resections (2014-2019) in 2 centres. A risk score was developed by testing several variables for a possible association with a subsequent ICU admission using stepwise logistic regression analyses, validated by the bootstrap resampling technique. Variables associated with ICU admission were assigned weighted scores based on their regression coefficients. These scores were summed for each patient to generate the ICU risk score, and patients were grouped into risk classes., Results: A total of 103 patients (3.3%) required an unplanned admission to the ICU after the operation. The average ICU stay was 17.6 days. The following variables remained significantly associated with ICU admission following logistic regression: male gender (P = 0.004), body mass index <18.5 (P = 0.002), predicted postoperative forced expiratory volume in 1 s < 60% (P = 0.004), predicted postoperative carbon monoxide lung diffusion capacity <50% (P = 0.013), open access (P = 0.004) and pneumonectomy (P = 0.041). All variables were weighted 1 point except body mass index <18.5 (2 points). The final ICU risk score ranged from 0 to 7 points. Patients were grouped into 6 risk classes showing an incremental unplanned ICU admission rate: class A (score 0), 0.7%; class B (score 1), 1.7%; class C (score 2), 3%; class D (score 3), 7.1%; class E (score 4), 12%; and class F (score > 4), 13% (P < 0.001)., Conclusions: This risk score may assist in reliably planning the response to a sudden increase in the demand of critical care resources., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2022
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41. Contemporary trends in the level of evidence in general thoracic surgery clinical research.

Author

Choe SI, Ben-Avi R, Begum H, Pearce K, Mehta M, Agzarian J, Finley CJ, Hanna WC, Farrokhyar F, and Shargall Y

Subjects
Evidence-Based Medicine, Humans, Reproducibility of Results, Research Design, Thoracic Surgery, Thoracic Surgical Procedures
Abstract

Objectives: The large volume of scientific publications and the increasing emphasis on high-quality evidence for clinical decision-making present daily challenges to all clinicians, including thoracic surgeons. The objective of this study was to evaluate the contemporary trend in the level of evidence (LOE) for thoracic surgery clinical research., Methods: All clinical research articles published between January 2010 and December 2017 in 3 major general thoracic surgery journals were reviewed. Five authors independently reviewed the abstracts of each publication and assigned a LOE to each of them using the 2011 Oxford Centre for Evidence-Based Medicine classification scheme. Data extracted from eligible abstracts included study type, study size, country of primary author and type of study designs. Three auditing processes were conducted to establish working definitions and the process was validated with a research methodologist and 2 senior thoracic surgeons. Intra-class correlation coefficient was calculated to assess inter-rater agreement. Chi-square test and Spearman correlation analysis were then used to compare the LOE between journals and by year of publication., Results: Of 2028 publications reviewed and scored, 29 (1.4%) were graded level I, 75 (3.7%) were graded level II, 471 (23.2%) were graded level III, 1420 (70.2%) were graded level IV and 33 (1.6%) were graded level V (lowest level). Most publications (94.9%) were of lower-level evidence (III-V). There was an overall increasing trend in the lower LOE (P < 0.001). Inter-rater reliability was substantial with 95.5% (95%, confidence interval: 0.95-0.96) level of agreement between reviewers., Conclusions: General thoracic surgery literature consists mostly of lower LOE studies. The number of lower levels of evidence is dominating the recent publications, potentially indicating a need to increase the commitment to produce and disseminate higher-level evidence in general thoracic surgery., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2022
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42. The histologic effects of neoadjuvant stereotactic body radiation therapy (SBRT) followed by pulmonary metastasectomy-rationale and protocol design for the Post SBRT Pulmonary Metastasectomy (PSPM) trial.

Author

Begum H, Swaminath A, Lee Y, Fahim C, Bramson J, Naqvi A, Shargall Y, Finley C, Hanna W, and Agzarian J

Abstract

Background: For the local management of pulmonary malignancies, surgical resection and stereotactic body radiation therapy (SBRT) are mutually exclusive treatments. This study aims to assess the effectiveness of SBRT on reducing tumor viability at a histologic level in the context of pulmonary metastases., Methods: This protocol describes an open-label unblinded single-arm prospective Phase 2 trial to determine the effects of dual treatment of pulmonary metastasis amenable to curative resection using neoadjuvant SBRT followed by surgical resection, the Post SBRT Pulmonary Metastasectomy (PSPM) trial. Sample size require 39 patients, with an anticipated study duration of 30-36 months. Following completion of SBRT, eligible patients will be assessed at the 4-6-week mark by the treating radiation oncologist and thoracic surgeon with a post-treatment computed tomography (CT) of the chest. Patients with no disease progression will undergo scheduled surgical resection of all metastatic tumors at 8-12 weeks post SBRT. Patients will then be evaluated postoperatively at 30 days, and every 6 months for a total of 36 months with surveillance CT scans. Patients will also undergo sequential serologic evaluation of circulating tumor DNA (ctDNA) levels throughout their respective treatment pathway. The primary outcome of this study is the rate of complete pathologic response (pCR) following SBRT, assess using the International Association for the Study of Lung Cancer (IASLC) multidisciplinary recommendations for pathologic assessment of lung cancer resection specimens after neoadjuvant therapy. Secondary outcomes include overall survival (OS), disease free survival (DFS), local recurrence rates, cancer histology effects on pCR and treatment related complications, and treatment effect on ctDNA levels. Primary and secondary outcomes will be analyzed using Fisher's Exact test and Student's t -test based on data type. Cox-proportional hazard ratios will be used to evaluate OS and DFS, using the log rank test., Discussion: In evaluating the effect of SBRT on pulmonary metastasis at a histologic level, this trial may increase the use of this modality in selected patients who would otherwise only undergo surgery for disease that has already metastasized. Also, the trial provides secondary benefits of evaluating the abscopal effects of radiation on pulmonary metastatic disease, and serves as a platform for more comprehensive large-scale research in this field., Trial Registration: ClinicalTrials.gov identifier: NCT04160143 (HiREB: 7925)., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tcr.amegroups.com/article/view/10.21037/tcr-22-232/coif). The authors have no conflicts of interest to declare., (2022 Translational Cancer Research. All rights reserved.)

Published
2022
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43. Outcomes of patients discharged home with a chest tube after lung resection: a multicentre cohort study.

Author

Minervini F, Hanna WC, Brunelli A, Farrokhyar F, Miyazaki T, Bertolaccini L, Scarci M, Coret M, Hughes K, Schneider L, Lopez-Hernandez Y, Agzarian J, Finley C, and Shargall Y

Subjects
Adult, Aftercare, Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Length of Stay, Lung, Male, Middle Aged, Pneumonectomy adverse effects, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications therapy, Retrospective Studies, Young Adult, Chest Tubes, Patient Discharge
Abstract

Background: Prolonged air leaks are increasingly treated in the outpatient setting, with patients discharged with chest tubes in place. We evaluated the incidence and risk factors associated with readmission, empyema development and further interventions in this patient population., Methods: We undertook a retrospective cohort analysis of all patients from 4 tertiary academic centres (January 2014 to December 2017) who were discharged home with a chest tube after lung resection for a postoperative air leak lasting more than 5 days. We analyzed demographics, patient factors, surgical details, hospital readmission, reintervention, antibiotics at discharge, empyema and death., Results: Overall, 253 of 2794 patients were analyzed (9.0% of all resections), including 30 of 759 from centre 1 (4.0%), 67 of 857 from centre 2 (7.8%), 9 of 247 from centre 3 (3.6%) and 147 of 931 from centre 4 (15.8%) ( p < 0.001). Our cohort consisted of 56.5% men, and had a median age of 69 (range 19-88) years. Despite similar initial lengths of stay ( p = 0.588), 49 patients (19.4%) were readmitted (21%, 0%, 23% and 11% from centres 1 to 4, respectively, p = 0.029), with 18 (36.7%) developing empyema, 11 (22.4%) requiring surgery and 3 (6.1%) dying. Only chest tube duration was a significant predictor of readmission ( p < 0.001) and empyema development ( p = 0.003), with a nearly threefold increased odds of developing empyema when the chest tube remained in situ for more than 20 days., Conclusion: Discharge with chest tube after lung resection is associated with serious adverse events. Given the high risk of empyema development, removal of chest tubes should be considered, when appropriate, within 20 days of surgery. Our data suggest a potential need for proactive postdischarge outpatient management programs to diminish risk of morbidity and death., Competing Interests: Competing interests: Alessandro Brunelli sits on advisory boards with Ethicon, Medtronic and AstraZeneca, and reports speaking honoraria from Medela and BD. No other competing interests were declared., (© 2022 CMA Impact Inc. or its licensors.)

Published
2022
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44. The Effect of Major and Minor Complications After Lung Surgery on Length of Stay and Readmission.

Author

Finley CJ, Begum HA, Pearce K, Agzarian J, Hanna WC, Shargall Y, and Akhtar-Danesh N

Abstract

The effect of post-operative adverse events (AEs) on patient outcomes such as length of stay (LOS) and readmissions to hospital is not completely understood. This study examined the severity of AEs from a high-volume thoracic surgery center and its effect on the patient postoperative LOS and readmissions to hospital. This study includes patients who underwent an elective lung resection between September 2018 and January 2020. The AEs were grouped as no AEs, 1 or more minor AEs, and 1 or more major AEs. The effects of the AEs on patient LOS and readmissions were examined using a survival analysis and logistic regression, respectively, while adjusting for the other demographic or clinical variables. Among 488 patients who underwent lung surgery, (Wedge resection [n = 100], Segmentectomy [n = 51], Lobectomy [n = 310], Bilobectomy [n = 10], or Pneumonectomy [n = 17]) for either primary (n = 440) or secondary (n = 48) lung cancers, 179 (36.7%) patients had no AEs, 264 (54.1%) patients had 1 or more minor AEs, and 45 (9.2%) patients had 1 or more major AEs. Overall, the median of LOS was 3 days which varied significantly between AE groups; 2, 4, and 8 days among the no, minor, and major AE groups, respectively. In addition, type of surgery, renal disease (urinary tract infection [UTI], urinary retention, or acute kidney injury), and ASA (American Society of Anesthesiology) score were significant predictors of LOS. Finally, 58 (11.9%) patients were readmitted. Readmission was significantly associated with AE group ( P  = 0.016). No other variable could significantly predict patient readmission. Overall, postoperative AEs significantly affect the postoperative LOS and readmission rates., Competing Interests: Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Published
2022
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45. Role of Adjuvant Therapy in Esophageal Cancer Patients After Neoadjuvant Therapy and Esophagectomy: A Systematic Review and Meta-analysis.

Author

Lee Y, Samarasinghe Y, Lee MH, Thiru L, Shargall Y, Finley C, Hanna W, Levine O, Juergens R, and Agzarian J

Subjects
Esophageal Neoplasms mortality, Esophageal Neoplasms surgery, Humans, Neoplasm Recurrence, Local, Recurrence, Survival Analysis, Chemotherapy, Adjuvant, Esophageal Neoplasms therapy, Esophagectomy, Neoadjuvant Therapy
Abstract

Objective: The aim of this study was to analyze esophageal cancer patients who previously underwent neoadjuvant therapy followed by a curative resection to determine whether additional adjuvant therapy is associated with improved survival outcomes., Summary Background Data: Neoadjuvant therapy followed by surgery is the standard of care for locally advanced esophageal cancer, whereas adjuvant therapy is typically employed for patients with residual disease. However, the role of adjuvant therapy after a curative resection is still uncertain., Methods: MEDLINE, EMBASE, and CENTRAL databases were searched for studies comparing patients with esophageal cancer who underwent neoadjuvant therapy and curative resection with and without adjuvant therapy. Primary outcome was overall survival (OS), and random effects meta-analysis was conducted where appropriate. Grading of recommendations, assessment, development, and evaluation was used to assess the certainty of evidence., Results: Ten studies involving 6462 patients were included. When compared to patients who received neoadjuvant therapy and esophagectomy alone, adjuvant therapy groups experienced a significant decrease in mortality by 48% at 1 year (Risk Ratio (RR) 0.52, 95% confidence interval [CI] 0.41-0.65, P < 0.001, moderate certainty). This reduction in mortality was carried through to 5-year follow-up (RR 0.91, 95% CI 0.86-0.96, P < 0.001, moderate certainty). The difference between the adjuvant therapy and the control group was uncertain regarding the secondary outcomes., Conclusion: Adjuvant therapy after neoadjuvant treatment and esophagectomy with negative resection margins provide an improved OS at 1 and 5 years with moderate to high certainty of evidence, but the benefit for disease-free survival and locoregional/distal recurrence remain uncertain due to limited reporting of these outcomes., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2022
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46. A narrative review of traumatic mediastinal injuries and their management: the thoracic surgeon perspective.

Author

Williams E and Agzarian J

Abstract

Objective: Mediastinal injuries are uncommon, rarely encountered and depending on the institution, can be managed by various sub-specialties. The purpose of this narrative review is to present an overview of traumatic mediastinal injuries, their presentation, and management options from the perspective of a thoracic surgeon., Background: Although infrequent, traumatic mediastinal injuries can pose significant morbidity and mortality. The infrequency of these injuries limits operative exposure for thoracic surgeons and trainees. A concise overview of common presentations and management options is warranted to further solidify important concepts., Methods: A search of the literature was conducted using MEDLINE, PubMed, and Embase for relevant articles pertaining to anatomic injuries of the mediastinum. The presentation of mediastinal injuries along with indications for non-operative versus operative management in cardiac injuries, thoracic esophageal injuries, tracheobronchial injuries, and injuries to the lungs and pleura was conducted and literature summarized., Conclusions: In providing this review it is hopeful to enhance knowledge and comfort in recognition and management of these uncommon yet potentially lethal injuries. Early involvement of thoracic surgery is recommended to ensure effective and efficient treatment., Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/med-21-13). The series “Traumatic Injuries of the Mediastinum” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare., (2021 Mediastinum. All rights reserved.)

Published
2021
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47. 2021 Canadian Surgery Forum: Virtual, online Sept. 21-24, 2021.

Author

Johnson G, Vergis A, Unger B, Park J, Gillman L, Hickey K, Pace D, Azin A, Guidolin K, Lam-Tin-Cheung K, Chadi S, Quereshy F, Guidolin K, Catton J, Rubin B, Bell J, Marangos J, Heesters A, Stuart-McEwan T, Quereshy F, Shariff F, Wright F, Ahmed N, Nadler A, Hallet J, Gentles J, Chen L, Hwang H, Parapini M, Hirpara D, Sidhu R, Scott T, Karimuddin A, Guo R, Nguyen A, Osborn J, Wiseman S, Nabata K, Ertel E, Hwang H, Lenet T, Baker L, Park L, Vered M, Zahrai A, Shorr R, Davis A, McIsaac D, Tinmouth A, Fergusson D, Martel G, Nabata K, Rummel S, Stefic-Cubic M, Karimuddin A, Stewart M, Melck A, McKechnie T, Anpalagan T, Ichhpuniani S, Lee Y, Ramji K, Eskicioglu C, Zhu A, Deng S, Greene B, Tsang M, Palter V, Jayaraman S, McKechnie T, Mann A, Tittley J, Cadeddu M, Nguyen M, Madani A, Pasternak J, McKechnie T, Ramji K, Hong D, Qu L, Istl A, Tang E, Gray D, Zuckerman J, Coburn N, Callum J, McLeod R, Pearsall E, Lin Y, Turgeon A, Martel G, Hallet J, Mahar A, Kammili A, Kriviraltcheva-Kaneva P, Lee L, Cools-Lartigue J, Ferri L, Mueller C, Zuckerman J, Haas B, Tillman B, Guttman M, Chesney T, Zuk V, Mahar A, Hsu A, Chan W, Vasdev R, Coburn N, Hallet J, D'Souza K, Huynh C, Ling LCJ, Warburton R, Hwang H, Hameed M, Glass L, Williamson H, Murphy P, Tang E, Leslie K, Hawel J, Kerr L, Zablotny S, Roldan H, He W, Jiang X, Zheng B, Lee L, Fiore J Jr, Feldman L, Fried G, Mueller C, Valanci S, Balvardi S, Cipolla J, Kaneva P, Demyttenaere S, Boutros M, Lee L, Feldman L, Fiore J, Balvardi S, Alhashemi M, Cipolla J, Lee L, Fiore J Jr, Feldman L, Miles A, Purich K, Verhoeff K, Shapiro J, Bigam D, Kung J, Fecso A, Chesney T, Mosko J, Skubleny D, Hamilton P, Ghosh S, Widder S, Schiller D, Do U, El Kefraoui C, Pook M, Barone N, Balvardi S, Montgomery H, Nguyen-Powanda P, Rajabiyazdi F, Elhaj H, Lapointe-Gagner M, Olleik G, Kaneva P, Antoun A, Safa N, Di Lena E, Meterissian S, Meguerditchian A, Fried G, Alhashemi M, Lee F, Baldini G, Feldman L, Fiore J Jr, Serrano Aybar PE, Parpia S, Ruo L, Tywonek K, Lee S, O'Neill C, Faisal N, Alfayyadh A, Gundayao M, Meyers BM, Habashi R, Kruse C, McKechnie T, Levin M, Aldrich K, Grantcharov T, Langerman A, Forbes H, Anantha R, Fawcett V, Hetherington A, Pravong V, Gervais M, Rakovich G, Selvam R, Hu R, Musselman R, Raiche I, Moloo H, Liu R, Elnahas A, Alkhamesi N, Hawel J, Tang E, Alnumay A, Schlachta C, Walser E, Zhang C, Cristancho S, Ott M, Lee A, Niu B, Balaa F, Gawad N, Ren K, Qiu Y, Hamann K, How N, Leveille C, Davidson A, Eqbal A, Sardiwalla Y, Korostensky M, McKechnie T, Lee E, Yang I, Ren K, Muaddi H, Stukel T, de Mestral C, Nathens A, Karanicolas P, Frigault J, Lemieux S, Breton D, Bouchard P, Bouchard A, Grégoire R, Letarte F, Bouchard G, Drolet S, Frigault J, Avoine S, Drolet S, Letarte F, Bouchard A, Gagné J, Thibault C, Grégoire R, Jutras Bouthillette N, Gosselin M, Bouchard P, Rosenzveig A, Stuleanu T, Jarrar A, Kolozsvari N, Skelhorne-Gross G, Nenshi R, Jerath A, Gomez D, Singh K, Amir T, Liu E, Farquharson S, Mao R, Lan L, Yan J, Allard-Coutu A, Mierzwa A, Tin R, Brisebois R, Bradley N, Wigen R, Walser E, Hartford L, Van Koughnett J, Vogt K, Hilsden R, Parry N, Allen L, Leslie K, Raskin R, Jones J, Neumann K, Dwyer C, Strickland M, Bradley N, O'Dochartaigh D, Lobay K, Kabaroff A, Chang E, Widder S, Anantha R, Sun W, Beck J, Anantha R, Liu R, Davidson J, Jones S, Van Hooren T, Van Koughnett J, Ott M, Schmitz E, Raiche I, Sun W, El Hafid M, Dang J, Mocanu V, Lutzak G, Sultanian R, Wong C, Karmali S, Schmitz E, Petrera M, Pickell M, Auer R, Patro N, Li B, Lee Y, Wilson H, Mocanu V, Sun W, Dang J, Jogiat U, Kung J, Switzer N, Karmali S, Wong C, Li C, Al Hinai A, Cieply A, Hawes H, Joos E, Saleh A, Li C, Saleh A, Engels P, Drung J, Allen L, Leslie K, Pang G, Kwong M, Schlachta C, Alkhamesi N, Hawel J, Elnahas A, Guidolin K, Ellsmere J, Chadi S, Quereshy F, Chang D, Hutter M, Spence R, Abou Khalil M, Boutros M, Vasilevsky C, Morin N, Longtin Y, Liberman S, Demyttenaere S, Montpetit P, Poirier M, Mukherjee K, Sebajang H, Younan R, Schwenter F, De Broux E, Larsen K, Skelhorne-Gross G, Beckett A, Nantais J, Gomez D, Lan L, Mao R, Kay J, Lohre R, Ayeni O, Goel D, de Sa D, He R, Hylton D, Bedard E, Johnson S, Laing B, Valji A, Hanna W, Turner S, Akhtar-Danesh G, Akhtar-Danesh N, Shargall Y, Akhtar-Danesh G, Akhtar-Danesh N, Shargall Y, Hirpara D, Gupta V, Kidane B, Limbachia J, Sullivan K, Farrokhyar F, Leontiadis G, Patel Y, Churchill I, Hylton D, Xie F, Seely A, Spicer J, Kidane B, Turner S, Yasufuku K, Hanna W, Jogiat U, Sun W, Dang J, Mocanu V, Kung J, Karmali S, Turner S, Switzer N, Patel Y, Churchill I, Sullivan K, Beauchamp M, Wald J, Mbuagbaw L, Agzarian J, Shargall Y, Finley C, Fahim C, Hanna W, Abbas M, Olaiya O, Begum H, Mbuagbaw L, Finley C, Hanna W, Agzarian J, Shargall Y, Ednie A, Palma D, Warner A, Malthaner R, Fortin D, Qiabi M, Nayak R, Nguyen T, Louie A, Rodrigues G, Yaremko B, Laba J, Inculet R, Alaichi J, Patel Y, Hanna W, Turner S, Mador B, Lai H, White J, Kim M, Hirpara D, Kidane B, Louie A, Zuk V, Darling G, Rousseau M, Chesney T, Coburn N, Hallet J, Lee Y, Samarasinghe Y, Lee M, Thiru L, Shargall Y, Finley C, Hanna W, Levine O, Juergens R, Agzarian J, Nayak R, Brogly S, Li W, Lougheed D, Petsikas D, Mistry N, Gatti A, Churchill I, Patel Y, Hanna W, Abdul S, Anestee C, Gilbert S, Sundaresan S, Seely A, Villeneuve P, Maziak D, Razzak R, Ashrafi A, Tregobov N, Hassanzadeh N, Stone S, Panjwani A, Bong T, Bond R, Hafizi A, De Meo M, Rayes R, Milette S, Vagai M, Usatii M, Chandrasekaran A, Giannias B, Bourdeau F, Sangwan V, Bertos N, Moraes C, Huang S, Quail D, Walsh L, Camilleri-Broet S, Fiset P, Cools-Lartigue J, Ferri L, Spicer J, Kammili A, Bilgic E, Quaiattini A, Maurice-Ventouris M, Najmeh S, Mueller C, Esther L, Begum H, Agzarian J, Hanna W, Finley C, Shargall Y, Lee Y, Lu J, Malhan R, Shargall Y, Finley C, Hanna W, Agzarian J, Brophy S, Brennan K, French D, Resende V, Momtazi M, Solaja O, Gilbert S, Maziak D, Seely A, Sundaresan S, Villeneuve P, Sisson D, Donahoe L, Bedard P, Hansen A, De Perrot M, Alghamedi A, Simone A, Begum H, Hanna W, Shargall Y, Turner S, Huang J, Lai H, Bedard E, Shargall Y, Murthy S, Lin J, Darling G, Malthaner R, Kidane B, Seely A, Li H, Crowther M, Linkins L, Lau E, Schneider L, Hanna W, Finley C, Agzarian J, Douketis J, Greenberg B, Gupta V, Allen-Avodabo C, Davis L, Zhao H, Kidane B, Darling G, Coburn N, Huynh C, Cools-Lartigue J, Ferri L, Najmeh S, Sirois C, Mulder D, Spicer J, Al Rawahi A, Aftab Abdul S, Nguyen D, Anstee C, Delic E, Gilbert S, Maziak D, Villeneuve P, Seely A, Sisson D, Sasewich H, Islam T, Low D, Darling G, Turner S, Humer M, Abdul S, Nguyen D, Al Rawahi A, Anstee C, Delic E, Gilbert S, Villeneuve P, Maziak D, Seely A, Le Nguyen D, Aftab Abdul S, Al Rawahi A, Anstee C, Delic E, Gilbert S, Villeneuve P, Maziak D, Seely A, Patel Y, Kay M, Churchill I, Sullivan K, Shargall Y, Shayegan B, Adili A, Hanna W, Kaafarani M, Huynh C, Chouiali F, Muthukrishnan N, Maleki F, Ovens K, Gold M, Sorin M, Falutz R, Rayes R, Forghani R, Spicer J, Hunka N, Kennedy R, Bigsby R, Bharadwaj S, Gowing S, Churchill I, Gatti A, Hylton D, Sullivan K, Patel Y, Farrokhyar F, Leontiadis G, Hanna W, Finley C, Begum H, Pearce K, Agzarian J, Hanna W, Shargall Y, Akhtar-Danesh N, Jones D, Anstee C, Kumar S, Gingrich M, Simone A, Ahmadzai Z, Thavorn K, Seely A, Gupta V, Namavarian A, Mohammed A, Uddin S, Jones D, Behzadi A, Brar A, Qu L, Qiabi M, Nayak R, Malthaner R, Peters E, Buduhan G, Tan L, Liu R, Srinathan S, Kidane B, Gupta V, Levy J, Kidane B, Mahar A, Ringash J, Sutradhar R, Darling G, Coburn N, Robinson M, Bednarek L, Buduhan G, Liu R, Tan L, Srinathan S, Kidane B, Wang H, French D, MacDonald D, Graham K, Enns S, Buduhan G, Srinathan S, Liu R, Tan A, Kidane B, Bruinooge A, Poole E, Pascoe C, Karakach T, Buduhan G, Tan L, Srinathan S, Halayko A, Kidane B, Verhoeff K, Mocanu V, Fang B, Dang J, Kung J, Switzer N, Birch D, Karmali S, Johnson G, Singh H, Vergis A, Park J, Hershorn O, Hochman D, Helewa R, Johnson G, Robertson R, Vergis A, Johnson G, Vergis A, Singh H, Park J, Helewa R, Azin A, Cahill C, Lipson M, Afzal A, Maclean A, Wong C, Roen S, Buie W, McKechnie T, Anpalagan T, Chu M, Lee Y, Amin N, Hong D, Eskicioglu C, McKechnie T, Ramji K, Kruse C, Jaffer H, Rebello R, Amin N, Doumouras A, Hong D, Eskicioglu C, Hajjar R, Oliero M, Cuisiniere T, Fragoso G, Calvé A, Djediai S, Annabi B, Richard C, Santos M, Purich K, Zhou Y, Dodd S, Ring B, Yuan Y, White J, Garfinkle R, Dell'Aniello S, Bhatnagar S, Morin N, Ghitulescu G, Faria J, Vasilevsky C, Brassard P, Boutros M, Garfinkle R, Salama E, Amar-Zifkin A, Morin N, Ghitulescu G, Faria J, Vasilevsky C, Boutros M, Talwar G, Daniel R, McKechnie T, Levine O, Eskicioglu C, AlSulaim H, Alqahtani M, Garfinkle R, Al-Masrouri S, Vasilevsky C, Morin N, Boutros M, McKechnie T, Chen A, Patel A, Lee Y, Doumouras A, Hong D, Eskicioglu C, Brissette V, Al Busaidi N, Rajabiyazdi F, Moon J, Demian M, Vasilevsky C, Morin N, Boutros M, Selvam R, Moloo H, MacRae H, Alam F, Raiche I, Holland J, Cwintal M, Rigas G, Vasilevsky C, Morin N, Ghitulescu G, Faria J, Pang A, Boutros M, Holland J, Moon J, Marinescu D, Morin N, Ghitulescu G, Pang A, Vasilevsky C, Boutros M, Brown C, Karimuddin A, Raval M, Phang P, Ghuman A, Li M, Muncner S, Mihajlovic I, Dykstra M, Snelgrove R, Wang H, Monton O, Smith A, Moon J, Demian M, Garfinkle R, Vasilevsky C, Rajabiyazdi F, Boutros M, AlAamer O, AlSelaim N, AlMalki M, Al-Osail A, Ruxton R, Manuel P, Mohamed F, Motamedi MK, Serahati S, Rajendran L, Brown C, Raval M, Karimuddin A, Ghuman A, Phang T, Caminsky N, Moon J, Rajabiyazdi F, Chadi S, Alavi K, Paquette I, MacLean T, Wexner S, Liberman S, Steele S, Park J, Patel S, Bordeianou L, Auer R, Sylla P, Morin N, Ghuman A, Boutros M, Bayat Z, Kennedy E, Victor C, Govindarajan A, Liang J, Vasilevsky C, Pang A, Ghitulescu G, Faria J, Morin N, Boutros M, Marinescu D, Roy H, Baig Z, Karimmudin A, Raval M, Brown C, Phang T, Gill D, Ginther N, Moon J, Marinescu D, Pang A, Ghitulescu G, Faria J, Morin N, Vasilevsky C, Boutros M, Moon J, Pang A, Ghitulescu G, Faria J, Morin N, Vasilevsky C, Boutros M, Salama E, Alrashid F, Vasilevsky C, Ghitulescu G, Faria J, Morin N, Boutros M, Wiseman V, Zhang L, MacDonald P, Merchant SM, Wattie Barnett K, Caycedo-Marulanda A, Patel SV, Harra Z, Vasilevsky C, Ghitulescu G, Morin N, Boutros M, Pang A, Hegagi M, Alqahtani M, Morin N, Ghitulescu G, Vasilevsky C, Boutros M, Alghaithi N, Marinescu D, Al-Masrouri S, Pang A, Vasilevsky C, Boutros M, Papillon E, Kasteel N, Kaur G, Bindra S, Malhotra A, Graham C, MacLean A, Beck P, Jijon H, Ferraz J, Buie W, Szwimer R, Moon J, Demian M, Pang A, Morin N, Vasilevsky C, Rajabiyazdi F, Boutros M, Azin A, Merchant S, Kong W, Gyawali B, Hanna T, Chung W, Nanji S, Patel S, Booth C, Li V, Awan A, Serrano P, Jacobson M, Chanco M, Wen V, Singh N, Peiris L, Pasieka J, Ghatage P, Buie D, MacLean T, Bouchard-Fortier A, Mack L, Marini W, Zheng W, Swallow C, Reedijk M, DiPasquale A, Peiris L, Prus-Czrnecka Z, Delmar L, Gagnon N, Villiard R, Martel É, Cadrin-Chênevert A, Ledoux É, Racicot C, Mysuria S, Bazzarelli A, Pao J, Chen L, Zhang M, McKevitt E, Warburton R, Kuusk U, Van Laeken N, Bovill E, Isaac K, Dingee C, Hunter-Smith A, Cuthbert C, Fergus K, Barbera L, Efegoma Y, Howell D, Isherwood S, Levasseur N, Scheer A, Simmons C, Srikantham A, Temple-Orberle C, Xu Y, Metcalfe K, Quan M, Alqaydi A, la J, Merchant S, Digby G, Pravong V, Brind'Amour A, Sidéris L, Dubé P, De Guerke L, Fortin S, Auclair M, Trilling B, Tremblay J, Di Lena É, Hopkins B, Wong S, Meterissian S, Di Lena É, Barone N, Hopkins B, Dumitra S, Kaneva P, Fiore J, Meterissian S, Mysuria S, McKevitt E, Warburton R, Chen L, Bazzarelli A, Pao J, Bovill E, Zhang M, Kuusk U, Isaac K, Van Laeken N, Dingee C, Kapur H, McKevitt E, Warburton R, Pao J, Dingee C, Bazarelli A, Kuusk U, Chen L, Cadili L, DeGirolamo K, McKevitt E, Pao J, Dingee C, Bazzarelli A, Warburton R, Ng D, Ali A, Eymae D, Lee K, Brar S, Conner J, Magalhaes M, Swallow C, Allen K, Baliski C, Cyr D, Sari A, Messenger D, Driman D, Assarzadegan N, Juda A, Swallow C, Kennedy E, Brar M, Conner J, Kirsch R, Allard-Coutu A, Singh K, Lamontagne A, Gamache Y, Allard-Coutu A, Mardinger C, Lee C, Duckworth R, Brindle M, Fraulin F, Austen L, Kortbeek J, Hyndman M, Nguyen D, Jamjoum G, Meguerditchian A, Langer S, Yuan Xu Y, Kong S, Quan M, Lim D, Retrouvey H, Kerrebijn I, Butler K, O'Neill A, Cil T, Zhong T, Hofer S, McCready D, Metcalfe K, Lim D, Greene B, Look Hong N, Parapini M, Skipworth J, Mah A, Desai S, Chung S, Scudamore C, Segedi M, Vasilyeva E, Li J, Kim P, Verhoeff K, Deprato A, Purich K, Kung J, Bigam D, Dajani K, Lenet T, Gilbert R, Smoot R, Martel G, Tzeng C, Rocha F, Yohanathan L, Cleary S, Bertens K, Reyna-Sepulveda F, Badrudin D, Gala-Lopez B, Hanna N, Brogly S, Wei X, Booth C, Nanji S, Zuckerman J, Coburn N, Mahar A, Callum J, Kaliwal Y, Jayaraman S, Wei A, Martel G, Hallet J, Zuckerman J, Jayaraman S, Wei A, Mahar A, Kaliwal Y, Martel G, Coburn N, Hallet J, Henault D, Barrette B, Pelletier S, Thebault P, Beaudry-Simoneau E, Rong Z, Plasse M, Dagenais ARM, Létourneau R, Lapointe R, Vandenbroucke-Menu F, Nguyen B, Soucy G, Turcotte S, Lemke M, Waugh E, Leslie K, Quan D, Skaro A, Tang E, Lund M, Allen L, Glinka J, Jada G, Quan D, Skaro A, Tang E, Park L, Daza J, Li V, Msallak H, Zhang B, Workneh A, Faisal S, Faisal R, Fabbro M, Gu C, Claassen M, Zuk V, Hallet J, Martel G, Sapisochin G, Serrano P, Glinka J, Skaro A, Leslie K, Jada G, Quan D, Tang E, Waugh E, Lemke M, Glinka J, Skaro A, Leslie K, Tang E, Waugh E, Breadner D, Liu R, Tang E, Allen L, Welch S, Skaro A, Leslie K, Glinka J, Waugh E, Tang E, Jada G, Quan D, Skaro A, Webb A, Lester E, Shapiro A, Eurich D, Bigam D, Essaji Y, Shrader H, Nayyar A, Suraju M, Williams-Perez S, Ear P, Chan C, Smith V, Rivers-Bowerman M, Costa A, Stueck A, Campbell N, Allen S, Gala-Lopez B, Gilbert R, Lenet T, Cleary S, Smoot R, Tzeng C, Rocha F, Martel G, Bertens K, Mir Z, Golding H, McKeown S, Nanji S, Flemming J, Groome P, Mir Z, Djerboua M, Nanji S, Flemming J, Groome P, Elbekri S, Turcotte S, Girard E, Morency-Potvin P, Lapointe R, Vandenbroucke-Menu F, Dagenais M, Roy A, Letourneau R, Plasse M, Simoneau E, Rong Z, Zuker N, Oakley M, Chartrand G, Misheva B, Bendavid Y, Frigault J, Lemieux S, Breton D, Bouchard G, Drolet S, Melland-Smith M, Smith L, Tan J, Kahn U, McLean C, Mocanu V, Birch D, Karmali S, Switzer N, Fortin M, Paré X, Doyon A, Keshavjee S, Schwenger K, Yadav J, Fischer S, Jackson T, Allard J, Okrainec A, Lee Y, Anvari S, Chu M, Lovrics O, Aditya I, Malhan R, Khondker A, Walsh M, Doumouras A, Hong D, He W, Vergis A, Hardy K, Romanescu R, Deaninck F, Linton J, Fowler-Woods M, Fowler-Woods A, Shingoose G, Vergis A, Hardy K, Zmudzinski M, Cloutier Z, McKechnie T, Lee Y, Archer V, Doumouras A, Shiroky J, Abu Halimah J, Ramji K, Boudreau V, Mierzwa A, Mocanu V, Marcil G, Dang J, Switzer N, Birch D, Karmali S, Mierzwa A, Jarrar A, Hardy-Henry A, Kolozsvari N, Lin W, Hagen J, Connell M, Sun W, Dang J, Mocanu V, Kung J, Switzer N, Birch D, and Karmali S

Subjects
Canada, Humans
Published
2021
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48. Double Blind Pilot Randomized Trial Comparing Extended Anticoagulation to Placebo Following Major Lung Resection for Cancer.

Author

Shargall Y, Schneider L, Linkins LA, Crowther M, Farrokhyar F, Waddell TK, de Perrot M, Douketis J, Lopez-Hernandez Y, Schnurr T, Haider E, Agzarian J, Hanna WC, and Finley C

Subjects
Humans, Lung, Pilot Projects, Treatment Outcome, Anticoagulants therapeutic use, Neoplasms
Abstract

Venous thromboembolism (VTE), which comprises pulmonary embolus (PE) and deep vein thrombosis (DVT), is a significant cause of postoperative morbidity and mortality. This pilot randomized control trial (RCT) evaluated the feasibility of a full-scale RCT investigating extended thromboprophylaxis in patients undergoing oncological lung resections. Patients undergoing oncological lung resections in 2 tertiary centers received in-hospital, thromboprophylaxis and were randomized to receive post-discharge low-molecular-weight heparin (LMWH) or placebo injections once-daily for 30 days. At 30 days postoperatively, all patients underwent chest computed tomography with PE protocol and bilateral leg venous ultrasound. Primary outcomes included feasibility and safety; VTE incidence and 90-day survival were secondary outcomes. Between December 2015 and June 2018, 619 patients were screened, of whom 62.7% (165/263) of eligible patients consented to participate, and 133 (81%) were randomized. One-hundred and 3 patients, (77.4%), completed the 90-day study follow-up. Reasons for non-participation pre-randomization included patient discomfort and LMWH/placebo administration challenges. Post-randomization withdrawals were due to patient preference, surgeon preference and minor adverse events. Six asymptomatic VTE events (5 PE and 1 DVT) were detected within 30 days (3 in each group), for an overall incidence of 7%. There were 3 minor and no major adverse events. This study is the first to demonstrate the feasibility and safety of a full-scale extended thromboprophylaxis RCT in thoracic surgical oncology. Our results demonstrate that, while recruitment and retention rates were modest, the study design is feasible and with minimal adverse events and no intervention-related mortality., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Published
2021
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49. Impact of the integrated comprehensive care program post-thoracic surgery: A propensity score-matched study.

Author

Ahmadi N, Mbuagbaw L, Finley C, Agzarian J, Hanna WC, and Shargall Y

Subjects
Aged, Emergency Service, Hospital, Female, Home Care Services, Humans, Length of Stay statistics & numerical data, Male, Middle Aged, Propensity Score, Retrospective Studies, Patient Readmission statistics & numerical data, Postoperative Care, Postoperative Complications prevention & control, Postoperative Complications therapy, Thoracic Surgical Procedures adverse effects, Thoracic Surgical Procedures methods
Abstract

Objective: Thoracic surgery is associated with significant rates of postoperative morbidity and postdischarge return to the hospital or emergency department (ED). This study aims to assess the impact of a novel integrated patient-centered, hospital-based multidisciplinary community program (Integrated Comprehensive Care [ICC]) on postdischarge outcomes in patients undergoing thoracic surgery compared to routine care., Methods: This was a retrospective cohort study of patients who underwent surgical resection for lung malignancies at a tertiary care center from 2010 to 2014. Patients were divided into 2 cohorts based on their enrollment in the ICC program (intervention cohort; 2012-2014) or routine postoperative care (control cohort; 2010-2012). Propensity score matching was performed to match the 2 cohorts. The impact of the ICC program on postoperative length of stay (LOS), rate of ED visits, readmissions, and mortality within the first 60 days was assessed., Results: Of the 1288 patients included in this study, 658 (51.1%) were male patients with mean age of 64 years (standard deviation 14.1 years). After propensity score matching, 478 patients were enrolled in the ICC cohort and 592 were enrolled as controls. The ICC cohort had significantly shorter LOS (4 days, vs 5 days in controls, P = .001), lower rate of 60-day ED visits (9.8% vs 28.4% in controls, P < .001), and readmissions (6.9% vs 8.6% in controls, P < .001). The 60-day mortality was also significantly lower in the ICC cohort compared with the control group (0.6% vs 0.8% in controls, P < .001)., Conclusions: The ICC program is associated with shorter LOS, fewer ED visits and readmissions after discharge, and ultimately may decrease postoperative mortality., (Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2021
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50. Endobronchial Ultrasound Staging of Operable Non-small Cell Lung Cancer: Do Triple-Normal Lymph Nodes Require Routine Biopsy?

Author

Hylton DA, Kidane B, Spicer J, Turner S, Churchill I, Sullivan K, Finley CJ, Shargall Y, Agzarian J, Seely AJE, Yasufuku K, and Hanna WC

Subjects
Aged, Aged, 80 and over, Bronchi, Carcinoma, Non-Small-Cell Lung secondary, Carcinoma, Non-Small-Cell Lung surgery, Female, Follow-Up Studies, Humans, Lung Neoplasms surgery, Lymphatic Metastasis diagnostic imaging, Male, Mediastinum, Middle Aged, Prospective Studies, Carcinoma, Non-Small-Cell Lung diagnosis, Endoscopic Ultrasound-Guided Fine Needle Aspiration methods, Endosonography methods, Lung Neoplasms diagnosis, Lymph Nodes diagnostic imaging, Pneumonectomy
Abstract

Background: Staging guidelines for lung cancer recommend endobronchial ultrasound (EBUS) and systematic biopsy of at least three mediastinal lymph node (LN) stations for accurate staging. A four-point ultrasonographic score (Canada Lymph Node Score [CLNS]) was developed to determine the probability of malignancy in each LN. A LN with a CLNS of < 2 is considered low probability for malignancy. We hypothesized that, in patients with cN0 non-small cell lung cancer, LNs with CLNS of < 2 may not require routine biopsy because they represent true node-negative disease., Research Question: Do LNs considered triple normal on CT scanning, PET scanning, and CLNS evaluation require routine biopsy?, Study Design and Methods: LNs were evaluated for ultrasonographic features at the time of EBUS and the CLNS was applied. Triple-normal LNs were defined as cN0 on CT scanning (short axis, < 1 cm), PET scanning (no hypermetabolic activity), and EBUS (CLNS, < 2). Specificity and negative predictive value (NPV) were calculated against the gold standard pathologic diagnosis from surgically excised specimens., Results: In total, 143 LNs from 57 cN0 patients were assessed. Triple-normal LNs showed a specificity and NPV of 60% (95% CI, 51.2%-68.3%) and 93.1% (95% CI, 85.6%-97.4%), respectively. After pathologic assessment, only 5.6% (n = 8/143) of triple-normal nodes were proven to be malignant., Interpretation: At the time of staging for lung cancer, combining CT scanning, PET scanning, and CLNS criteria can identify triple-normal LNs that have a high NPV for malignancy. This raises the question of whether triple-normal LNs require routine sampling during EBUS and transbronchial needle aspiration. A prospective trial is required to confirm these findings., (Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

Published
2021
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