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1. Management of complications in patients with an ileostomy: an umbrella review of systematic reviews for the EndOTrial Consortium.

Author

Solitano V, Vuyyuru SK, Yuan Y, Singh S, Narula N, Ma C, Hanzel J, Hutton M, Van Koughnett JA, Rieder F, and Jairath V

Subjects
Humans, Crohn Disease surgery, Crohn Disease complications, Postoperative Complications etiology, Postoperative Complications therapy, Systematic Reviews as Topic, Ileostomy adverse effects
Abstract

Background: Standardized clinical care processes for patients with Crohn's disease (CD) and a permanent ileostomy (PI) are lacking. The EndOTrial consortium aims to address this gap by developing pathways for care., Methods: In this umbrella review, we searched major databases for relevant systematic reviews (SRs) or scoping reviews (ScR) published until January 5, 2024. Screening, data extraction, and quality appraisal (AMSTAR 2) were performed by two independent reviewers., Results: Of 1349 screened papers, 22 reviews met our inclusion criteria, including 20 SRs (eight with meta-analysis) and 2 ScRs. None exclusively focused on PI. Furthermore, nine reviews did not mention patients with inflammatory bowel disease (IBD), and only two reviews included patients with high-output ileostomy, highlighting a large evidence gap. The identified reviews covered six categories with nine types of interventions, including ostomy care pathways, peristomal skin care, patient education, clinical management of high-output stoma, management and prevention of postoperative ileus, dietary and nutritional support, nursing and supporting care, telemedicine, and self-management interventions. Most SRs including nursing interventions for stoma care highlighted nurses' role in a variety of standard and specialized treatments. Notably, none of the reviews exclusively examined disease recurrence, stoma pouching systems or adhesives, behavioral interventions, or mental health in patients living with ileostomy., Conclusions: Evidence for best practice interventions to treat complications and improve quality of life in patients living with an ileostomy for CD is limited and heterogeneous. These results outline the need for standardized clinical care processes and pathways tailored to the unique needs of this patient population., (© 2024. The Author(s).)

Published
2024
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2. 2023 Canadian Surgery Forum: Sept. 20-23, 2023.

Author

Brière R, Émond M, Benhamed A, Blanchard PG, Drolet S, Habashi R, Golbon B, Shellenberger J, Pasternak J, Merchant S, Shellenberger J, La J, Sawhney M, Brogly S, Cadili L, Horkoff M, Ainslie S, Demetrick J, Chai B, Wiseman K, Hwang H, Alhumoud Z, Salem A, Lau R, Aw K, Nessim C, Gawad N, Alibhai K, Towaij C, Doan D, Raîche I, Valji R, Turner S, Balmes PN, Hwang H, Hameed SM, Tan JGK, Wijesuriya R, Tan JGK, Hew NLC, Wijesuriya R, Lund M, Hawel J, Gregor J, Leslie K, Lenet T, McIsaac D, Hallet J, Jerath A, Lalu M, Nicholls S, Presseau J, Tinmouth A, Verret M, Wherrett C, Fergusson D, Martel G, Sharma S, McKechnie T, Talwar G, Patel J, Heimann L, Doumouras A, Hong D, Eskicioglu C, Wang C, Guo M, Huang L, Sun S, Davis N, Wang J, Skulsky S, Sikora L, Raîche I, Son HJ, Gee D, Gomez D, Jung J, Selvam R, Seguin N, Zhang L, Lacaille-Ranger A, Sikora L, McIsaac D, Moloo H, Follett A, Holly, Organ M, Pace D, Balvardi S, Kaneva P, Semsar-Kazerooni K, Mueller C, Vassiliou M, Al Mahroos M, Fiore JF Jr, Schwartzman K, Feldman L, Guo M, Karimuddin A, Liu GP, Crump T, Sutherland J, Hickey K, Bonisteel EM, Umali J, Dogar I, Warden G, Boone D, Mathieson A, Hogan M, Pace D, Seguin N, Moloo H, Li Y, Best G, Leong R, Wiseman S, Alaoui AA, Hajjar R, Wassef E, Metellus DS, Dagbert F, Loungnarath R, Ratelle R, Schwenter F, Debroux É, Wassef R, Gagnon-Konamna M, Pomp A, Richard CS, Sebajang H, Alaoui AA, Hajjar R, Dagbert F, Loungnarath R, Sebajang H, Ratelle R, Schwenter F, Debroux É, Wassef R, Gagnon-Konamna M, Pomp A, Santos MM, Richard CS, Shi G, Leung R, Lim C, Knowles S, Parmar S, Wang C, Debru E, Mohamed F, Anakin M, Lee Y, Samarasinghe Y, Khamar J, Petrisor B, McKechnie T, Eskicioglu C, Yang I, Mughal HN, Bhugio M, Gok MA, Khan UA, Fernandes AR, Spence R, Porter G, Hoogerboord CM, Neumann K, Pillar M, Guo M, Manhas N, Melck A, Kazi T, McKechnie T, Jessani G, Heimann L, Lee Y, Hong D, Eskicioglu C, McKechnie T, Tessier L, Archer V, Park L, Cohen D, Parpia S, Bhandari M, Dionne J, Eskicioglu C, Bolin S, Afford R, Armstrong M, Karimuddin A, Leung R, Shi G, Lim C, Grant A, Van Koughnett JA, Knowles S, Clement E, Lange C, Roshan A, Karimuddin A, Scott T, Nadeau K, Macmillan J, Wilson J, Deschenes M, Nurullah A, Cahill C, Chen VH, Patterson KM, Wiseman SM, Wen B, Bhudial J, Barton A, Lie J, Park CM, Yang L, Gouskova N, Kim DH, Afford R, Bolin S, Morris-Janzen D, McLellan A, Karimuddin A, Archer V, Cloutier Z, Berg A, McKechnie T, Wiercioch W, Eskicioglu C, Labonté J, Bisson P, Bégin A, Cheng-Oviedo SG, Collin Y, Fernandes AR, Hossain I, Ellsmere J, El-Kefraoui C, Do U, Miller A, Kouyoumdjian A, Cui D, Khorasani E, Landry T, Amar-Zifkin A, Lee L, Feldman L, Fiore J, Au TM, Oppenheimer M, Logsetty S, AlShammari R, AlAbri M, Karimuddin A, Brown C, Raval MJ, Phang PT, Bird S, Baig Z, Abu-Omar N, Gill D, Suresh S, Ginther N, Karpinski M, Ghuman A, Malik PRA, Alibhai K, Zabolotniuk T, Raîche I, Gawad N, Mashal S, Boulanger N, Watt L, Razek T, Fata P, Grushka J, Wong EG, Hossain I, Landry M, Mackey S, Fairbridge N, Greene A, Borgoankar M, Kim C, DeCarvalho D, Pace D, Wigen R, Walser E, Davidson J, Dorward M, Muszynski L, Dann C, Seemann N, Lam J, Harding K, Lowik AJ, Guinard C, Wiseman S, Ma O, Mocanu V, Lin A, Karmali S, Bigam D, Harding K, Greaves G, Parker B, Nguyen V, Ahmed A, Yee B, Perren J, Norman M, Grey M, Perini R, Jowhari F, Bak A, Drung J, Allen L, Wiseman D, Moffat B, Lee JKH, McGuire C, Raîche I, Tudorache M, Gawad N, Park LJ, Borges FK, Nenshi R, Jacka M, Heels-Ansdell D, Simunovic M, Bogach J, Serrano PE, Thabane L, Devereaux PJ, Farooq S, Lester E, Kung J, Bradley N, Best G, Ahn S, Zhang L, Prince N, Cheng-Boivin O, Seguin N, Wang H, Quartermain L, Tan S, Shamess J, Simard M, Vigil H, Raîche I, Hanna M, Moloo H, Azam R, Ko G, Zhu M, Raveendran Y, Lam C, Tang J, Bajwa A, Englesakis M, Reel E, Cleland J, Snell L, Lorello G, Cil T, Ahn HS, Dube C, McIsaac D, Smith D, Leclerc A, Shamess J, Rostom A, Calo N, Thavorn K, Moloo H, Laplante S, Liu L, Khan N, Okrainec A, Ma O, Lin A, Mocanu V, Karmali S, Bigam D, Bruyninx G, Georgescu I, Khokhotva V, Talwar G, Sharma S, McKechnie T, Yang S, Khamar J, Hong D, Doumouras A, Eskicioglu C, Spoyalo K, Rebello TA, Chhipi-Shrestha G, Mayson K, Sadiq R, Hewage K, MacNeill A, Muncner S, Li MY, Mihajlovic I, Dykstra M, Snelgrove R, Wang H, Schweitzer C, Wiseman SM, Garcha I, Jogiat U, Baracos V, Turner SR, Eurich D, Filafilo H, Rouhi A, Bédard A, Bédard ELR, Patel YS, Alaichi JA, Agzarian J, Hanna WC, Patel YS, Alaichi JA, Provost E, Shayegan B, Adili A, Hanna WC, Mistry N, Gatti AA, Patel YS, Farrokhyar F, Xie F, Hanna WC, Sullivan KA, Farrokhyar F, Patel YS, Liberman M, Turner SR, Gonzalez AV, Nayak R, Yasufuku K, Hanna WC, Mistry N, Gatti AA, Patel YS, Cross S, Farrokhyar F, Xie F, Hanna WC, Haché PL, Galvaing G, Simard S, Grégoire J, Bussières J, Lacasse Y, Sassi S, Champagne C, Laliberté AS, Jeong JY, Jogiat U, Wilson H, Bédard A, Blakely P, Dang J, Sun W, Karmali S, Bédard ELR, 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

Published
2023
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3. Gender trends in applicants to general surgery residency programs in Canada.

Author

Ahmed A, Davidson J, Van Koughnett JA, and Bütter A

Subjects
Child, Humans, Male, Female, Canada, Cross-Sectional Studies, Retrospective Studies, Career Choice, Internship and Residency, General Surgery
Abstract

Background: Surgical disciplines lag behind non-surgical disciplines in attracting female trainees. Female representation of Canadian General Surgeons has not been evaluated in recent years in the literature. The objectives of this study were to assess gender trends in applicants to Canadian General Surgery residency programs and practicing general surgeons and subspecialists., Methods: This retrospective cross-sectional study analyzed gender data for residency applicants ranking General Surgery as their first-choice discipline from publicly-available annual Canadian Residency Matching Service (CaRMS) R-1 match reports from 1998 to 2021. Aggregate gender data for practicing female physicians in General Surgery and related subspecialties, including Pediatric Surgery, obtained from annual Canadian Medical Association (CMA) census from 2000 to 2019 was also analysed., Results: There was a significant increase in the proportion of female applicants from 34% in 1998 to 67% in 2021 (p < 0.001) and of successfully matched candidates from 39% to 68% (p = 0.002) from 1998 to 2021. Success rates between male and female candidates were significantly different in 1998 (p < 0.001), but not in 2021 (p = 0.29). The proportion of practicing female General Surgeons also significantly increased from 10.1% in 2000 to 27.9% in 2019 (p = 0.0013), with variable trends in subspecialties., Conclusion: Gender inequality in General Surgery residency matches has normalized since 1998. Despite females representing more than 40% of applicants and successfully matched candidates to General Surgery since 2008, a gender gap still exists amongst practicing General Surgeons and subspecialists. This suggests the need for further cultural and systemic change to mitigate gender disparities., Type of Study: Original research article, clinical research., Level of Evidence: Level III (Retrospective cross-sectional study)., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Published
2023
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4. "The Most Crushing Thing": Understanding Resident Assessment Burden in a Competency-Based Curriculum.

Author

Ott MC, Pack R, Cristancho S, Chin M, Van Koughnett JA, and Ott M

Subjects
Humans, Canada, Competency-Based Education, Curriculum, Learning, Clinical Competence, Internship and Residency
Abstract

Background: Competency-based medical education (CBME) was expected to increase the workload of assessment for graduate training programs to support the development of competence. Learning conditions were anticipated to improve through the provision of tailored learning experiences and more frequent, low-stakes assessments. Canada has adopted an approach to CBME called Competence by Design (CBD). However, in the process of implementation, learner anxiety and assessment burden have increased unexpectedly. To mitigate this unintended consequence, we need a stronger understanding of how resident assessment burdens emerge and function., Objective: This study investigates contextual factors leading to assessment burden on residents within the framework of CBD., Methods: Residents were interviewed about their experiences of assessment using constructivist grounded theory. Participants (n=21) were a purposive sample from operative and perioperative training programs, recruited from 6 Canadian medical schools between 2019 and 2020. Self-determination theory was used as a sensitizing concept to categorize findings on types of assessment burden., Results: Nine assessment burdens were identified and organized by threats to psychological needs for autonomy, relatedness, and competence. Burdens included: missed opportunities for self-regulated learning, lack of situational control, comparative assessment, lack of trust, constraints on time and resources, disconnects between teachers and learners, lack of clarity, unrealistic expectations, and limitations of assessment forms for providing meaningful feedback., Conclusions: This study contributes a contextual understanding of how assessment burdens emerged as unmet psychological needs for autonomy, relatedness, and competence, with unintended consequences for learner well-being and intrinsic motivation.

Published
2022
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5. Opioid use after outpatient elective general surgery: quantifying the burden of persistent use.

Author

Clarke C, McClure A, Allen L, Hartford L, Van Koughnett JA, Gray D, Murphy PB, Vinden C, Leslie K, and Vogt KN

Abstract

Purpose: Surgery is a major risk factor for chronic opioid use among patients who had not recently been prescribed opioids. This study identifies the rate of, and risk factors for, persistent opioid use following laparoscopic cholecystectomy and open inguinal hernia repair in patients not recently prescribed opioids., Methods: This retrospective population-based cohort study included all patients who had not been prescribed opioids in the 6 months prior to undergoing open inguinal hernia repair or laparoscopic cholecystectomy from January 2013 to July 2016 in Ontario. Opioid prescription was identified from the provincial Narcotics Monitoring System and data were obtained from the Institute for Clinical Evaluative Sciences. The primary outcome was persistent opioid use after surgery (3, 6, 9 and 12 months). Associated risk factors and prescribing patterns were also examined., Results: Among the 90,326 patients in the study cohort, 80% filled an opioid prescription after surgery, with 11%, 9%, 5% and 1% filling a prescription at 3, 6, 9 and 12 months, respectively. Significant variability was identified in the type of opioid prescribed (41% codeine, 31% oxycodone, 18% tramadol) and in regional prescribing patterns (mean prescription/region range, 135-225 oral morphine equivalents). Predictors of continued opioid use included age, female gender, lower income quintile and being operated on by less experienced surgeons., Conclusion: Most patients who undergo elective cholecystectomy and hernia repair will fill a prescription for an opioid after surgery, and many will continue to fill opioid prescriptions for considerably longer than clinically anticipated. There is important variability in opioid type, regional prescribing patterns and risk factors that identify strategic targets to reduce the opioid burden in this patient population., Competing Interests: Conflict of interest: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The British Pain Society 2021.)

Published
2022
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6. Synchronous colonic B cell lymphoma and adenocarcinoma in an elderly patient treated with R-mini-CHOP followed by resection.

Author

Schep D, Van Koughnett JA, Velker V, and Correa RJM

Subjects
Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cyclophosphamide therapeutic use, Doxorubicin therapeutic use, Humans, Male, Prednisone therapeutic use, Vincristine therapeutic use, Adenocarcinoma diagnosis, Adenocarcinoma drug therapy, Adenocarcinoma surgery, Colonic Neoplasms drug therapy, Colonic Neoplasms pathology, Colonic Neoplasms surgery, Lymphoma drug therapy, Lymphoma, B-Cell drug therapy
Abstract

The simultaneous diagnosis of colonic lymphoma and adenocarcinoma in the same location is rare and presents challenges in its treatment considerations, especially in elderly patients. While previous cases have been described, there is little consistency in treatment regimens, and outcomes are generally poor. We describe the case of a man in his late 80s who presented with primary cecal and colonic B cell lymphoma, treated with R-mini-CHOP chemotherapy, but was found to have a residual adenocarcinoma in the cecum after treatment that was then successfully resected. The patient remains alive and well 3 years postoperation. This case highlights the need to consider lymphoma as a possible diagnosis for any colonic mass, and the need to consider rebiopsy of residual abnormal-appearing tissue postchemotherapy to confirm the diagnosis. Moreover, our report affirms that aggressive, curative-intent treatment with age-adjusted chemotherapy, and subsequent surgical resection is feasible for certain elderly patients with dual malignant diagnoses., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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7. The fatigue paradox: Team perceptions of physician fatigue.

Author

Field E, Lingard L, Cherry R, Van Koughnett JA, DeLuca S, and Taylor T

Subjects
Fatigue, Grounded Theory, Humans, Patient Care Team, Internship and Residency, Physicians
Abstract

Objectives: Ongoing calls to implement fatigue risk management in residency education assume a shared understanding of physician fatigue as a workplace hazard, yet we lack empirical evidence that all health care team members maintain this assumption. Thus, this study seeks to explore how health care team members understand the role of physician fatigue in an effort to inform the implementation of fatigue risk management in residency training and medical practice., Methods: This study uses constructivist grounded theory to explore perceptions of workplace fatigue and its impact on clinical practice. We conducted individual semi-structured interviews with physicians, nurses and senior residents across four hospitals in 8 different specialties for a total of 40 participants. Constant comparative analysis guided data analysis and led to the final grounded theory., Results: While participants outlined multiple problematic manifestations of physician fatigue on clinical performance, they were reluctant to acknowledge any negative impact of fatigue on patient care. We refer to these contradictions as the fatigue paradox. Four key themes sustain the fatigue paradox: the indefatigable physician, blind spots, faith in safety nets and the minimisation of fatigue-related events., Conclusions: This study suggests that health care team members do not universally feel that physician fatigue is problematic for patient care, despite providing multiple examples to the contrary. This paradoxical understanding of fatigue likely exists because the system relies on fatigued physicians, particularly trainees, and provides few mechanisms to critically examine fatigue. Successful implementation of fatigue risk management in residency training may prove elusive if clinical supervisors are skeptical of the potentially negative impact of workplace fatigue., (© 2021 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Published
2021
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8. Are we generating more assessments without added value? Surgical trainees' perceptions of and receptiveness to cross-specialty assessment.

Author

Burm S, Sebok-Syer SS, Van Koughnett JA, and Watling CJ

Subjects
Canada, Clinical Competence standards, Clinical Competence statistics & numerical data, Competency-Based Education methods, Competency-Based Education standards, Education, Medical, Graduate methods, Education, Medical, Graduate statistics & numerical data, Educational Measurement methods, Educational Measurement statistics & numerical data, Focus Groups methods, Formative Feedback, Humans, Motivation, Qualitative Research, Surgeons education, Surgeons trends, Education, Medical, Graduate standards, Educational Measurement standards, Medicine methods, Perception, Surgeons psychology
Abstract

Introduction: Competency-based medical education (CBME) hinges on robust assessment. However, integrating regular workplace-based assessment within demanding and sometimes chaotic clinical environments remains challenging. Many faculty lack assessment expertise, and some programs lack the infrastructure and faculty numbers to fulfill CBME's mandate. Recognizing this, we designed and implemented an assessment innovation that trains and deploys a cadre of faculty to assess in specialties outside their own. Specifically, we explored trainees' perceptions of and receptiveness to this novel assessment approach., Methods: Within Western University's Surgical Foundations program, 27 PGY‑1 trainees were formatively assessed by trained non-surgeons on a basic laparoscopic surgical skill. These assessments did not impact trainees' progression. Four focus groups were conducted to gauge residents' sentiments about the experience of cross-specialty assessment. Data were then analyzed using a thematic analysis approach., Results: While a few trainees found the experience motivating, more often trainees questioned the feedback they received and the practicality of this assessment approach to advance their procedural skill acquisition. What trainees wanted were strategies for improvement, not merely an assessment of performance., Discussion: Trainees' trepidation at the idea of using outside assessors to meet increased assessment demands appeared grounded in their expectations for assessment. What trainees appeared to desire was a coach-someone who could break their performance into its critical individual components-as opposed to an assessor whose role was limited to scoring their performance. Understanding trainees' receptivity to new assessment approaches is crucial; otherwise training programs run the risk of generating more assessments without added value.

Published
2020
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9. Spin Is Common in Studies Assessing Robotic Colorectal Surgery: An Assessment of Reporting and Interpretation of Study Results.

Author

Patel SV, Van Koughnett JA, Howe B, and Wexner SD

Subjects
Conflict of Interest, Humans, Outcome Assessment, Health Care, Research Design, Research Support as Topic, Colorectal Surgery methods, Data Interpretation, Statistical, Disclosure statistics & numerical data, Prejudice statistics & numerical data, Randomized Controlled Trials as Topic statistics & numerical data, Research Report, Robotic Surgical Procedures
Abstract

Background: Spin has been defined previously as "specific reporting that could distort the interpretation of results and mislead readers.", Objective: The purpose of this study was to determine the frequency and extent of misrepresentation of results in robotic colorectal surgery., Data Sources: Publications referenced in MEDLINE or EMBASE between 1992 and 2014 were included in this study., Study Selection: Studies comparing robotic colorectal surgery with other techniques with a nonsignificant difference in the primary outcome(s) were included., Interventions: Interventions included robotic versus alternative techniques., Main Outcome Measures: Frequency, strategy, and extent of spin, as previously defined, were the main outcome measures, Results: : A total of 38 studies (including 24,303 patients) were identified for inclusion in this study. Evidence of spin was found in 82% of studies. The most common form of spin was concluding equivalence between surgical techniques based on nonsignificant differences (76% of abstracts and 71% of conclusions). Claiming improved benefits, despite nonsignificance, was also commonly observed (26% of abstracts and 45% of conclusions). Because of the small sample size, we did not find evidence of an association between spin and study design, type of funding, publication year, or study size. Acknowledging the equivocal nature of the study happened rarely (47% of abstracts and 34% of conclusions). The absence of spin predicted whether authors acknowledged equivocal results (p = 0.02). A total of 50% of studies did not disclose whether they received funding, whereas 39% of studies failed to state whether a conflict of interest existed., Limitations: A limited number of randomized controlled trials were available., Conclusions: Spin occurred in >80% of included studies. Many studies concluded that robotic surgery was as safe as more traditional techniques, despite small sample sizes and limited follow-up. Authors often failed to recognize the difference between nonsignificance and equivalence. Failure to disclose financial relationships, which could represent potential conflict(s) of interest, is concerning. Readers of these articles need to be critical of author conclusions, and publishers should ensure that conclusions correspond with the study methods and results.

Published
2015
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10. Negative pressure wound therapy use to decrease surgical nosocomial events in colorectal resections (NEPTUNE): study protocol for a randomized controlled trial.

Author

Chadi SA, Vogt KN, Knowles S, Murphy PB, Van Koughnett JA, Brackstone M, and Ott MC

Subjects
Clinical Protocols, Cross Infection diagnosis, Cross Infection economics, Cross Infection microbiology, Digestive System Surgical Procedures economics, Home Care Services, Hospital Costs, Humans, Intention to Treat Analysis, Length of Stay, Ontario, Patient Readmission, Prospective Studies, Research Design, Risk Factors, Surgical Wound Infection diagnosis, Surgical Wound Infection economics, Surgical Wound Infection microbiology, Time Factors, Treatment Outcome, Colon surgery, Cross Infection prevention & control, Digestive System Surgical Procedures adverse effects, Negative-Pressure Wound Therapy adverse effects, Negative-Pressure Wound Therapy economics, Rectum surgery, Surgical Wound Infection prevention & control
Abstract

Background: Surgical site infections (SSIs) are the second most common form of nosocomial infection. Colorectal resections have high rates of SSIs secondary to the inherently contaminated intraluminal environment. Negative pressure wound therapy dressings have been used on primarily closed incisions to reduce surgical site infections in other surgical disciplines. No randomized control trials exist to support the use of negative pressure wound therapy following elective open colorectal resection to reduce surgical site infection., Methods/design: In this single-center, superiority designed prospective randomized open blinded endpoint controlled trial, patients scheduled for a colorectal resection via a laparotomy will be considered eligible. Patients undergoing laparoscopic resection will be enrolled but only randomized and included if the operation is converted to an open procedure. Exclusion criteria are patients receiving an abdominoperineal resection or a palliative procedure, as well as pregnant patients and those with an adhesive allergy. After informed consent, 300 patients will be randomized to the use of a standard adhesive gauze dressing or to a negative pressure wound device. Patients will be followed in hospital and reassessed on post-operative day 30. The primary outcome measure is SSI within the first 30 post-operative days. Secondary outcomes include the length of hospital stay, the number of return visits related to a potential or actual SSI, cost, and the need for homecare. The primary endpoint analysis follows the intention-to-treat principle., Discussion: NEPTUNE is the first randomized controlled trial to investigate the role of incisional negative pressure wound therapy in decreasing the rates of surgical site infections in the abdominal incisions of patients following an elective, open colorectal resection. This low-risk intervention may help decrease the morbidity and costs associated with the development of an SSI in our patients., Trial Registration: NCT02007018--clinicaltrials.gov; 5 December 2013.

Published
2015
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11. Modern multidisciplinary perioperative management of rectal cancer.

Author

Berho M, Narang R, Van Koughnett JA, and Wexner SD

Subjects
Humans, Neoadjuvant Therapy, Neoplasm Staging, Patient Care Team, Perioperative Care, Rectal Neoplasms diagnosis, Rectal Neoplasms surgery
Abstract

Importance: The management of care for rectal cancer has undergone many changes and improvements in recent decades. A multidisciplinary approach to this complex disease is essential to ensure high-quality treatment and outcomes., Objective: To present a current, evidence-based approach to the multidisciplinary team management of rectal cancer with a review of the diagnosis, staging, and treatment of the disease by radiologists, oncologists, surgeons, and pathologists., Evidence Review: The literature review was conducted through online searches of MEDLINE and PubMed. Articles published between January 1, 2000, and June 2014 and pertaining to staging modalities, surgical approaches, pathologic assessment, and medical treatments of rectal cancer were considered. All studies were reviewed, with preferential inclusion of larger or randomized trials. The review focused on changing paradigms and current controversies in rectal cancer management., Findings: A multidisciplinary approach to the patient with rectal cancer includes many health care professionals. Although treatments continue to evolve and improve, clear evidence-based principles have been well studied. The important roles of various specialists must be acknowledged and utilized. Within each role, new and emerging treatment approaches require critical review by experts in their fields., Conclusions and Relevance: Many new technologies and treatment options will continue to advance the treatment of rectal cancer, further emphasizing the need for a multidisciplinary approach to achieve optimal care.

Published
2015
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12. A new combined technique of reinforced parastomal hernia repair.

Author

Silva E, Szomstein S, Van Koughnett JA, Rosenthal R, and Wexner S

Subjects
Aged, Hernia, Ventral etiology, Herniorrhaphy instrumentation, Humans, Laparoscopy instrumentation, Male, Surgical Mesh, Suture Techniques, Sutures, Colostomy, Hernia, Ventral surgery, Herniorrhaphy methods, Laparoscopy methods, Postoperative Complications surgery
Published
2014
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13. Local excision of T1 and T2 rectal cancer: proceed with caution.

Author

Elmessiry MM, Van Koughnett JA, Maya A, DaSilva G, Wexner SD, Bejarano P, and Berho M

Subjects
Adenocarcinoma mortality, Adenocarcinoma pathology, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Neoplasm Recurrence, Local etiology, Neoplasm Recurrence, Local prevention & control, Neoplasm Staging, Rectal Neoplasms mortality, Rectal Neoplasms pathology, Retrospective Studies, Survival Rate, Treatment Outcome, Adenocarcinoma surgery, Microsurgery, Natural Orifice Endoscopic Surgery, Rectal Neoplasms surgery, Rectum surgery
Abstract

Aim: This study aimed to compare the clinical outcome between local excision (LE) and total mesorectal excision (TME) for early rectal cancer., Method: After Institutional Review Board approval, charts of patients with T1 or T2 N0M0 rectal adenocarcinoma treated by curative LE or TME without preoperative radiotherapy from 2004 to 2012 were reviewed. Categorical and continuous variables were compared using chi-square analysis and the ANOVA test. Kaplan-Meier analysis compared survival rates., Results: The study included 153 patients: 79 underwent TME and 74 LE. Postoperative infection was more common after TME (P = 0.009). There was tumour involvement of the margins in 13.5% after LE compared with 0% after TME (P = 0.001). Of the patients treated initially by LE, 13.5% had additional surgery for unfavourable histological findings and 4.1% had residual tumour. Median follow up was 35 (17-96) months. No deaths were recorded in 56 patients with a pT1 lesion. There was no significant difference in local recurrence (P = 0.332) or 3-year disease-free survival (DFS; P = 0.232) between patients having LE or TME. The 68 patients with a T2 lesion had higher local recurrence (P = 0.025) and lower DFS following LE compared with TME (P = 0.044). There was no difference in overall survival (P = 0.351)., Conclusion: LE of early rectal cancer is associated with higher local recurrence and decreased DFS. These disadvantages are significant for T2 lesions., (Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.)

Published
2014
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14. Surgery. NSAIDs and risk of anastomotic leaks after colorectal surgery.

Author

Van Koughnett JA and Wexner SD

Subjects
Female, Humans, Male, Anastomotic Leak chemically induced, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Colon surgery, Elective Surgical Procedures, Ileum surgery, Ketorolac adverse effects, Perioperative Care adverse effects, Rectum surgery
Abstract

NSAIDs provide improved pain control and reduce the use of opioids--both important components of enhanced recovery programs after colorectal surgery. However, the possible association between NSAID use and anastomotic leaks is greatly debated. Anastomotic leak remains an important concern due to the substantial associated morbidity.

Published
2014
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15. Current management of fecal incontinence: choosing amongst treatment options to optimize outcomes.

Author

Van Koughnett JA and Wexner SD

Subjects
Fecal Incontinence diagnosis, Fecal Incontinence etiology, Fecal Incontinence physiopathology, Humans, Patient Selection, Quality of Life, Recovery of Function, Risk Factors, Severity of Illness Index, Treatment Outcome, Defecation, Fecal Incontinence therapy, Intestines physiopathology
Abstract

The severity of fecal incontinence widely varies and can have dramatic devastating impacts on a person's life. Fecal incontinence is common, though it is often under-reported by patients. In addition to standard treatment options, new treatments have been developed during the past decade to attempt to effectively treat fecal incontinence with minimal morbidity. Non-operative treatments include dietary modifications, medications, and biofeedback therapy. Currently used surgical treatments include repair (sphincteroplasty), stimulation (sacral nerve stimulation or posterior tibial nerve stimulation), replacement (artificial bowel sphincter or muscle transposition) and diversion (stoma formation). Newer augmentation treatments such as radiofrequency energy delivery and injectable materials, are minimally invasive tools that may be good options before proceeding to surgery in some patients with mild fecal incontinence. In general, more invasive surgical treatments are now reserved for moderate to severe fecal incontinence. Functional and quality of life related outcomes, as well as potential complications of the treatment must be considered and the treatment of fecal incontinence must be individualized to the patient. General indications, techniques, and outcomes profiles for the various treatments of fecal incontinence are discussed in detail. Choosing the most effective treatment for the individual patient is essential to achieve optimal outcomes in the treatment of fecal incontinence.

Published
2013
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16. Anorectal physiology and testing.

Author

Van Koughnett JA and da Silva G

Subjects
Anal Canal physiopathology, Anus Diseases physiopathology, Defecography, Digital Rectal Examination, Electromyography, Endosonography, Humans, Magnetic Resonance Imaging, Manometry, Muscle, Smooth physiology, Muscle, Smooth physiopathology, Pudendal Nerve physiopathology, Rectal Diseases diagnosis, Rectal Diseases physiopathology, Rectum physiopathology, Anal Canal physiology, Anus Diseases diagnosis, Pudendal Nerve physiology, Rectum physiology
Abstract

A good understanding of anorectal physiology is essential for the diagnosis and appropriate treatment of various anorectal disorders, such as fecal incontinence, constipation, and pain. This article reviews the physiology of the anorectum and details the various investigations used to diagnose anorectal physiology disorders. These anatomic and functional tests include anal manometry, endoanal ultrasound, defecography, balloon expulsion test, magnetic resonance imaging, pudendal nerve terminal motor latency, electromyography, and colonic transit studies. Indications for investigations, steps in performing the tests, and interpretation of results are discussed., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Published
2013
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17. The use of trauma transfusion pathways for blood component transfusion in the civilian population: a systematic review and meta-analysis.

Author

Vogt KN, Van Koughnett JA, Dubois L, Gray DK, and Parry NG

Subjects
Acute Lung Injury etiology, Blood Coagulation Tests, Blood Component Transfusion adverse effects, Blood Component Transfusion statistics & numerical data, Emergencies, Evaluation Studies as Topic, Evidence-Based Medicine, Hemorrhage etiology, Hemorrhage mortality, Humans, Military Medicine methods, Research Design, Treatment Outcome, Blood Component Transfusion methods, Critical Pathways, Hemorrhage therapy, Wounds and Injuries complications
Abstract

This study was undertaken to determine if, amongst civilian trauma patients requiring massive transfusion (MT), the use of a formal trauma transfusion pathway (TTP), in comparison with transfusion without a TTP, is associated with a reduction in mortality, or changes in indices of coagulation, blood product utilisation and complications. A systematic review of three bibliographic databases, reference lists and conference proceedings was conducted. Studies were included if comparisons were made between patients receiving transfusion with and without a TTP. Data were extracted by two independent reviewers on population characteristics, transfusion strategies, blood product utilisation, indices of coagulation, clinical outcomes and complications. Data were pooled using a random effects model and heterogeneity explored. Seven observational studies met all eligibility criteria. Amongst 1801 patients requiring MT, TTPs were associated with a significant reduction in mortality (RR 0·69, 95% CI 0·55, 0·87). No significant increase in the mean number of PRBC transfused between TTP and control patients was seen (MD -1·17 95% CI -2·70, 0·36). When studies assessing only trauma patients were considered, TTPs were associated with a reduction in the mean number of units of plasma transfused (MD -2·63, 95% CI -4·24, -1·01). In summary, the use of TTPs appears to be associated with a reduction in mortality amongst trauma patients requiring MT without a clinically significant increase in the number of PRBC transfused and a potential reduction in plasma transfusion. Effects of TTPs on platelet transfusion, indices of coagulation and complications remain unclear. A randomised controlled trial is warranted., (© 2012 The Authors. Transfusion Medicine © 2012 British Blood Transfusion Society.)

Published
2012
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18. Canadian Surgery Forum: Abstracts of presentations to the Annual Meetings of the Canadian Association of Bariatric Physicians and Surgeons, Canadian Association of General Surgeons, Canadian Association of Thoracic Surgeons, Canadian Hepato-Pancreato-Biliary Society, Canadian Society of Surgical Oncology, Canadian Society of Colon and Rectal Surgeons, London, Ont. Sept. 15-18, 2011.

Author

Chiu JC, Shi X, Karmali S, Birch DW, Apriasz I, Alkhamesi NA, Lal A, Schlachta CM, Christou NV, Elkassem S, Lindsay D, Smith L, Sullivan P, Sockalingam S, Hawa R, Wnuk S, Jackson T, Okrainec A, Fayez R, Christou NV, Court O, Mueller C, Okrainec A, Sockalingham S, Jackson T, Mueller C, Swanson T, Daigle C, Okrainec A, Pitzul K, Penner T, Urbach DR, Jackson T, Sandhu L, Maciver A, McCall M, Edgar R, Thiesen A, Bigam D, Churchill T, Shapiro AMJ, Luu S, Regehr G, Murnaghan ML, Gallinger S, Moulton CA, Palter V, Grantcharov T, Dath D, Hoogenes J, Matsumoto E, Szalay D, Fox A, Pitzul K, Bhojani F, Kaplan M, Wei A, McGilvray I, Cleary SP, Okrainec A, Alqahtani A, Parsyan A, Payne R, Tabah R, Anantha R, Vogt K, Crawford S, Parry N, Leslie K, Ochs A, Matthew K, Khadaroo R, Churchill T, Lavoie JM, Zalai C, Vasilevsky CA, Booy J, Takata J, Tomlinson G, Urbach DR, Lim D, Tomlinson C, LaBossiere J, Rommens K, Birch DW, Brenneman F, MacLellan S, Simpson J, Asai K, Elgadi K, Ali S, Sawyer J, Helewa R, Turner D, Wirtzfeld D, Park J, Czaykowski P, Mak G, Hochman D, McKay A, Gill R, Al-Adra D, Shi X, Sample C, Armstrong J, Lester L, Vogt K, Brackstone M, Lee L, Kaneva P, Liberman S, Charlebois P, Stein B, Fried G, Feldman L, Kanji A, Sharon E, Asai K, Jacks L, McCready D, Ghazarian D, Leong WL, Wu R, Okrainec A, Penner T, Ball C, Kirkpatrick A, Vasquez A, Balakrishnan L, Miller G, Awan S, Azadeh NR, Hoogenes J, Dath D, Jain V, Busato GM, Cristea O, Landau J, Moreland R, Johnson M, Ramage D, Browning D, Ullah S, Cristea O, Bodrogi A, Johnson M, McAlister V, Palisoc J, Anderson J, Kiladze R, Ciar J, Bancel I, Pitzul K, Leake PA, Okrainec A, Dalvi A, McLean R, Stephen W, Loeb M, Smith R, Christoffersen E, Forbes S, Kidane B, Vogt K, Vinden C, Ahmadi N, Dubois L, McKenzie M, Baxter N, Brown C, Chaudhury P, Dixon E, Fitzgerald W, Henteleff H, Kirkpatrick A, Latosinsky S, MacLean A, McLeod R, Pearsall E, Aarts MA, Meghji Z, McLeod R, Okrainec A, Tran T, Kaneva P, Fried G, Mayo N, Feldman L, Newman D, Bergman S, Cummings BA, Delisle M, Whitehead V, Chertkow H, Chan T, Cicero M, Perampaladas K, Bandukwala T, Struble J, Moser M, Young P, Groeneveld A, Chan P, Smith S, Khadaroo R, Buczkowski A, Hameed M, Tan-Tam C, Meneghetti A, Simons R, Panton N, Elnahas A, Ghaderi I, Madani A, de Gara C, Schlachta CM, Kalechstein S, Pitzul K, Henao O, Okrainec A, Paskar D, Croome K, Hernandez R, Knapp G, Howatt N, Foster S, Cameron B, Austin J, Mack L, Temple W, Puloski S, Schachar N, Gill T, Doris P, Tecson A, Kolozsvari N, Andalib A, Kaneva P, Cao J, Vassiliou M, Fried G, Feldman L, Kolozsvari N, Kaneva P, Vassiliou M, Fried G, Feldman L, Kolozsvari N, Kaneva P, Brace C, Chartrand G, Vaillancourt M, Cao J, Banaszek D, Vassiliou M, Fried G, Feldman L, Fraser S, Bergman S, Deobald R, Chad J, Di Gregorio C, Johnstone J, Kenyon C, Lees M, Auger-Dufour E, Fried G, Feldman L, Ferri L, Vassiliou M, Alqahtani A, Perlman R, Holcroft C, Gordon PH, Szilagyi A, Iradukunda D, Moser MAJ, Rodych N, Shaw JM, Ahmed N, Chiu M, Kurabi B, Qureshi A, Nathens A, Conn LG, Pandya A, Kitto S, Ma G, Pooni A, Forbes S, Eskicioglu C, Pearsall E, Brenneman F, McLeod R, Rockx MA, McAlister V, Roberts D, Ouellet J, Kirkpatrick A, Lall R, Sutherland F, Ball C, Chackungal S, Knowlton LM, Dahn B, McQueen K, Morrison JA, Lent B, Brown J, Fluit M, Herbert C, Deen S, Deutschmann M, McFadden S, Gelfand G, Bosch D, Grimmer L, Milman S, Ng T, Gill R, Perry T, Abele J, Bedard E, Schiller D, Coughlin S, Stewart TC, Parry N, Gray D, Williamson J, Malthaner R, Bottoni D, Perri M, Trejos AL, Naish M, Patel R, Malthaner R, Ashrafi A, Bond J, Ong S, Yamashita M, Ahmadi S, Abdulmosen M, Miller J, Finley C, Ostrander K, Shargall Y, Lee L, Hanley S, Robineau C, Sirois C, Mulder D, Ferri L, Humphrey R, Inculet R, Fortin D, Arab A, Malthaner R, Ashrafi A, Bond J, Ong S, Yamashita M, Ahmadi S, McGuire A, Reid K, Petsikas D, Hopman W, Basi A, Basi S, Irshad K, Hanna W, Croome KP, Marotta P, McAlister V, Quan D, Wall W, Hernandez-Alejandro R, de Mestral C, Zagorski B, Rotstein O, Gomez D, Haas B, Laupacis A, Sharma S, Bridge J, Nathens A, Bhojani F, Fox A, Pitzul K, Moulton CA, Wei A, Okrainec A, Cleary S, Bertens K, Croome KP, Mujoomdar A, Peck D, Rankin R, Quan D, Kakani N, Hernandez-Alejandro R, Suri R, Marcaccio M, Ruo L, Jamal M, Khalil JA, Simoneau-Beaudry E, Dumitra S, Edwards M, Yousef Y, Jiffry MA, Metrakos P, Tchervenkov J, Doi S, Barkun J, Obayan A, Meiers S, Keith R, Elkassem S, Church N, Mitchell P, Turbide C, Dixon E, Debru E, Shum J, Wall WJ, Maniar R, Hochman D, Wirtzfeld D, Yaffe C, Yip B, McKay A, Silverman R, Park J, Francescutti V, Rivera L, Kane JM, Skitzki JJ, Lovrics P, Hodgson N, O'Brien MA, Thabane L, Cornacchi S, Heller B, Reid S, Sanders K, Kittmer T, Simunovic M, Duhaime S, Fong B, Deria M, Acton C, El-Maadawy M, Lad S, Arnaout A, Omole M, Pemberton J, Lovrics P, Bischof D, Stotland P, Hagen J, Swallow C, Klein L, Van Koughnett JA, Ahmad T, Ainsworth P, Brackstone M, Kanagaratnam S, Groot G, VanderBeek L, Francescutti V, Farrokhyar F, Strang B, Kahnamoui K, MacLellan S, MacKay H, Ringash J, Jacks L, Kassam Z, Khalili I, Conrad T, Okrainec A, Chagpar R, Xing Y, You N, Yi-Ju C, Feig B, Chang G, Cormie J, Gervais MK, Sideris L, Drolet P, Mitchell A, Leblanc G, Dubé P, Merchant S, Knowling M, Cheifetz R, Raval M, Heidary B, Kalikias S, Raval D, Phang T, Brown C, Scheer A, O'Connor A, Chan B, Moloo H, Poulin E, Mamazza J, Auer R, Boushey R, Hardy K, Vergis A, Sullivan P, Musselman R, Gomes T, Chan B, Auer R, Moloo H, Poulin E, Mamazza J, Al-Khayal K, Al-Omran M, Mamdani M, AlObeed O, Boushey R, Martel G, Crawford A, Barkun J, Ramsay C, Fergusson D, Boushey R, Williams L, Crawford A, McLaughlin K, Mackey M, Moloo H, Mamazza J, Poulin E, Friedlich M, Boushey R, Auer R, Bellolio F, Cohen Z, MacRae H, O'Connor B, Huang H, Victor JC, McLeod R, Hardy K, Pitzul K, Kwong J, Vergis A, Urbach D, Okrainec A, Vogt K, Dubois L, Vinden C, Chan B, Scheer A, Menezes A, Moloo H, Poulin E, Boushey R, Mamazza J, Bellolio F, MacRae H, Cohen Z, O'Connor B, Huang H, McLeod R, Godbout-Simard C, Azar J, Psaradellis F, Sampalis J, Morin N, Brown C, Kalikias S, Heidary B, Raval D, Phang PT, Raval M, Archibald A, Hurlbut D, Vanner S, Zalai C, Vasilevsky CA, Simunovic M, Cadeddu M, Forbes S, Kelly S, Stephen W, Grubac V, Marcinow M, Coates A, Aslani N, Phang PT, Raval M, Brown C, Scheer A, Carrier M, Boushey R, Asmis T, Wells P, Jonker D, Auer R, Azer N, Gill R, de Gara C, Birch DW, Karmali S, Roxin G, Drolet S, MacLean A, Buie WD, Heine J, Agzarian J, Forbes S, Stephen W, Kelly S, Churchill P, Corner T, Kelly S, Forbes S, Lindsay L, Stephen W, Scheer A, O'Connor A, Chan B, Moloo H, Poulin E, Mamazza J, Auer R, Boushey R, Denis J, Hochman D, Recsky M, Phang PT, Raval M, Cheung W, Brown C, Alkhamesi N, Schlachta CM, Tiwari T, Brown C, Raval MJ, and Phang PT

Published
2011

19. Canadian Surgery Forum.

Author

Atlas H, Safa N, Denis R, Garneau P, Moustarah F, Marceau S, Lebel S, Biertho L, Hould F, Marceau P, Biron S, Anvari M, Sharma A, Goldsmith CH, Lacobellis G, Cadeddu M, Misra M, Taylor V, Tarride J, Hubert E, Tiboni M, Hong D, Wiebe S, Klassen D, Bonjer J, Lawlor D, Plowman J, Ransom T, Vallis M, Ellsmere J, Graham PJ, Kaban GK, Vizhul A, Birch DW, Menezes AC, Shi X, Karmali S, Seth R, MacKenzie L, Kus A, Bell J, Carrier M, Atkins H, Boushey R, Auer R, Croome KP, Yamashita M, Aarts MA, Okrainec A, Glicksman A, Pearsall E, Pitzul K, Huang H, McLeod RS, Sarkhosh K, Robertson M, Boctor D, Lam V, Sigalet D, Johner A, Faulds J, Wiseman SM, Pemberton J, Gordon ML, Prashad C, Rambaran M, Cameron B, Neville A, Sarosi GA Jr, Wei Y, Gibbs JO, Reda DJ, McCarthy M Jr, Fitzgibbons RJ Jr, Barkun JST, Fenech DS, Forbes S, Pearsall E, Chung J, Glickman A, Victor JC, Nathens A, McLeod RS, Fitzmaurice GJ, Mone F, Brown R, Cranley B, Conlon EF, Todd RAJ, O'Donnell ME, Tran TT, Kaneva PA, Finch LE, Fried GM, Mayo NE, Feldman LS, VanHouwellingen L, Vogt KN, Stewart TC, Williamson J, Parry N, DeRose G, Gray D, Harriman S, Rodych N, Hayes P, Moser M, Jamal MH, Doi S, Rousseau M, Snell L, Meterissian S, Zolfaghari S, Friedlich MS, Kurashima Y, Al-Sabah S, Kaneva PA, Feldman LS, Fried GM, Vassiliou MC, Tran TT, Kaneva PA, Mayo NE, Fried GM, Feldman LS, Pearsall E, Sheth U, Fenech D, McKenzie M, Victor JC, McLeod RS, Ghaderi I, Vaillancourt M, Sroka G, Kaneva PA, Vassiliou MC, Seagull FJ, Sutton E, Godinez C, George I, Park A, Choy I, Okrainec A, Brintzenhoff R, Prabhu A, Heniford BT, Stefanidis D, Fried GM, Feldman LS, Igric A, Vogt KN, Girotti M, Parry NG, Vinden C, Kim SHH, Zhang NN, Russo JJ, El-Salfiti IK, Kowalczuk M, Rajaee AN, Bal M, Gill MS, Lysecki PJ, Hoogenes J, Dath D, Nassar AK, Reid S, Mohaisen KN, Winch J, Omar D, Hanna WC, Mulder DS, El-Hilali MM, Khwaja KA, Jamal MH, Rayment J, Doi SA, Megueditchian A, Meterissian S, Tso D, Langer M, Blair G, Butterworth S, Vaillancourt M, Vassiliou MC, Bergman S, Fried GM, Kaneva PA, Feldman LS, Davenport E, Haggar F, Trottier D, Huynh H, Soto C, Shamji FM, Seely A, Sundaresan S, Pagliarello G, Tadros S, Yelle JD, Maziak D, Moloo H, Poulin EC, Mamazza J, Knowlton LM, Chackungal S, MacQueen KA, Anvari M, Allen C, Goldsmith C, Ghaderi I, Madani A, de Gara C, Schlachta CM, Zakrison TL, Tee MC, Chan S, Nguyen V, Yang J, Holmes D, Levine D, Bugis S, Wiseman SM, Sandhu L, Zhai J, Kennedy ED, Baxter NN, Gagliardi AR, Urbach DR, Wei AC, Sabalbal M, McAlister VC, Balayla J, Bergman S, Feldman LS, Ghitulescu G, Fraser SA, Daigle R, Urquart R, Cox M, Grunfeld E, Porter G, Hallet J, Labidi S, Clairoux A, Gagné JP, Gill RS, Manouchehri N, Liu JQ, Lee TF, Bigam DL, Cheung PY, Van Koughnett JA, Colquhoun PH, Gordon ML, Cornacchi S, Farrokhyar F, Hodgson N, Porter G, Quan ML, Wright F, Lovrics P, Datta I, Brar SS, Ball CG, Heine JA, Rothwell B, Crozier M, Ting H, Boone D, O'Regan N, Brown C, Bandrauk N, Hapgood J, Hogan M, McDonald LA, Da'as S, Sorensen PHB, Berman JN, Ameer A, Jamal M, Aljiffry M, Doi S, Hasanain M, Chaudhury P, Metrakos P, Tchervenkov J, Lapierre S, Mohammad W, Balaa N, Akil M, Mimeault R, Fairfull-Smith R, Teague BD, Butler MS, Garneau PY, Sample CB, Kapoor A, Cadeddu MO, Anvari M, Hanna WC, Jamal MH, Nguyen L, Fraser SA, Kwan K, Wallis CJD, Jones S, Fraser T, Masterso J, Blair G, Duffy D, Roberts DJ, Kirkpatrick AW, Datta I, Feliciano DV, Kortbeek JB, Laupland KB, Ball CG, Haggar F, Davenport E, Moloo H, Mamazza J, Manouchehri N, Bigam D, Churchill T, Joynt C, Cheung PY, Al-Sairafi R, Sample CB, Paquette F, Fraser SA, Feldman LS, Fried GM, Weissglas I, Ghitulescu G, Meterissian S, Bergman S, Al-Dohayan A, Al-Naami M, Bamehriz F, Madkhali A, Hallet J, LeBlanc M, Gilbert A, Daigle C, Tien G, Atkins MS, Zheng B, Tanin H, Swindells C, Meneghetti A, Panton ONM, Qayumi AK, Chhiv M, Drolet S, Sirois-Giguère É, Gilbert A, Doyle JD, Sheth U, Huang H, Pearsall E, McLeod RS, Nathens AB, Suri RR, Vora P, Kirby JM, Chan K, Smith S, Ruo L, Faryniuk A, Hochman D, Ball CG, Kirkpatrick AW, Broderick TJ, Williams DR, Kholdebarin R, Helewa R, Bracken J, Zabolotny B, Hochman D, Merchant S, Hameed M, Melck A, McGuire AL, Wilson C, Mercer D, Sharma B, Orzech N, Grantcharov T, Johner A, Taylor DC, Buczkowski AK, Chung SW, Lumb KJ, Trejos AL, Ward CDW, Naish MD, Patel RV, Schlachta CM, Davenport E, Haggar F, Moloo H, Boushey RP, Poulin EC, Mamazza J, Graybiel KM, Fernandes VT, Hoogenes J, Dath D, Mohammad W, Trottier D, Nadolny K, Poulin EC, Mamazza J, Balaa F, Diederichs B, Turner S, de Gara C, Ghitulescu GA, Filip I, Bergman S, Fraser S, Finley RJ, Mayo J, Clifton J, Yee J, Evans K, MacWilliams A, Lam S, English J, Finley C, Jacks L, Darling G, Hanna WC, Sudarshan M, Roberge D, David M, Waschke KA, Mayrand S, Ferri LE, Coughlin S, Emmerton-Coughlin H, Malthaner R, Grover HS, Basi S, Chiasson P, Basi S, Irshad K, Emmerton-Coughlin HMA, Vogt KN, Malthaner RA, Spicer JD, McDonald B, Perera R, Rousseau MC, Chan CHF, Hsu RYC, Giannias B, Ferri LE, Ahmed S, Birnbaum AE, Berz D, Fontaine JP, Dipetrillo TA, Ready NE, Ng T, Alhussaini A, Oberoi M, Threader J, Villeneuve J, Gilbert S, Shamji FM, Sundaresan S, Maziak D, Seely A, Rammohan KS, Hunt I, Chuck A, Gazala S, Valji A, Stewart K, Bedard ELR, Plourde M, Fortin D, Arab A, Inculet RI, Malthaner RA, Bharadwaj SC, Hamin T, Tan LA, Unruh HW, Srinathan SK, McGuire AL, Petsikas D, Reid K, Hopman W, Levine P, Rousseau M, Spicer J, Ferri LE, Ashrafi AS, Bond RJ, Ong SR, Ahmadi SY, Partington SL, Graham AJ, Owen S, Kelly EJ, Gelfand G, Grondin SC, McFadden SD, Paolucci EO, Weeks SG, Davis PJ, Molinari M, Topp T, Walsh MJ, Simoneau E, Hassanain M, Cabrera T, Chaudhury P, Dumitra S, Aljiffry M, Feteih I, Leduc S, Rivera J, Jamal M, Valenti D, Metrakos P, Elgadi K, Cherniak W, Chan D, Wei AC, Gallinger S, Mohammad W, Mimeault R, Fairfull-Smith R, Auer R, Balaa F, Kwan J, Hassanain M, Chaudhury P, Dey C, Gadahadh R, Salman A, Simoneau E, Meti N, Aljiffry M, Jamal M, Cabrera T, Bouganim N, Kavan P, Alcindor T, Valenti D, Metrakos P, Brar B, Sutherland F, Bégin A, Bourdonnais D, Lapointe R, Plasse M, Létourneau R, Roy A, Dagenais M, Vandenbroucke-Menu F, Bégin A, Bourdonnais D, Lapointe R, Plasse M, Létourneau R, Dagenais M, Roy A, Vandenbroucke-Menu F, Bégin A, Ismail S, Vandenbroucke-Menu F, Létourneau R, Plasse M, Roy A, Dagenais M, Lapointe R, Greco EF, Nanji S, Shah SA, Wei AC, Greig PD, Gallinger S, Cleary SP, Al-Adra DP, Anderson C, Nanji S, Ryan P, Guindi M, Selvarajah S, Greig P, McGilvray I, Taylor B, Wei A, Moulton C, Cleary SP, Gallinger S, Sandroussi C, Brace C, Kennedy E, Baxter N, Gallinger S, Wei AC, Yamashita T, Leslie K, McLean SR, Karsanji D, Dixon E, Sutherland FR, Bathe OF, Suri RR, Marcaccio MJ, Ruo L, Jamal MH, Simoneau E, Khalil JA, Hassanain M, Chaudhury P, Tchervenkov J, Metrakos P, Doi SA, Barkun JS, Barnett C, Marcaccio MJ, Hankinson JJ, Ruo L, Alawashez A, Ellsmere J, Neville A, Boutros M, Barkun J, Wiebe ME, Sandhu L, Takata JL, Kennedy ED, Baxter NN, Gagliardi AR, Urbach DR, Wei AC, Chan G, Kocha W, Reid R, Wall W, Quan D, Lovrics P, Hodgson N, Ghola G, Franic S, Goldsmith C, McCready D, Cornacchi S, Garnett A, Reedijk M, Scheer AS, McSparron JI, Schulman AR, Tuorto S, Gonen M, Gonsalves J, Fong Y, Auer RAC, Francescutti V, Coates A, Thabane L, Goldsmith CH, Levine M, Simunovic M, Richardson DP, Porter G, Johnson PM, Leon-Carlyle M, Schmocker S, O'Connor BI, Victor JC, Baxter NN, Smith AJ, McLeod RS, Kennedy ED, Chan CHF, Arabzadeh A, DeMarte L, Spicer JD, Turbide C, Brodt P, Beauchemin N, Ferri LE, Zih F, Panzarella T, Hummel C, Petronis J, McCart A, Swallow C, Mathieson A, Ridgway PF, Ko YJ, Smith AJ, Gieni M, Dickson L, Sne N, Avram R, Farrokhyar F, Smith M, Giacomantonio C, Hoskin D, Doyon C, Martin G, Patocskai E, Brar SS, Wright F, Okrainec A, Smith AJ, Bischof DA, Maier B, Fitch M, Wright FC, Baliski CR, Kluftinger A, MacLeod M, Kwong S, Racz JM, Fortin A, Latosinsky S, Messenger DE, Kirsch R, McLeod RS, Aslani N, Heidary B, Prabhu KL, Raval M, Phang PT, Brow C, Richardson DP, Porter G, Johnson PM, Moloo H, Haggar F, Duhaime S, Hutton B, Grimshaw J, Coyle D, Poulin EC, Mamazza J, Boushey RP, Paun BC, Shaheen AAM, Dixon E, Maclean AR, Buie WD, Moustarah F, Talarico J, Zink J, Gatmaitan P, Schauer P, Chand B, Brethauer S, Martel G, Duhaime S, Ramsay CR, Barkun JS, Ferguson DA, Boushey RP, Palter VN, MacRae HM, Grantcharov TP, Messenger DE, Victor JC, O'Connor BI, MacRae HM, McLeod RS, Al-Sabah S, Feldman LS, Charlebois P, Stein B, Kaneva PA, Fried GM, Liberman AS, Borowiec AM, Karmal S, Apriasz I, Mysliwiec B, Hussain N, Ott M, Reynolds R, Lum A, Williams LJ, Morash R, Shin S, Smylie J, Moloo H, Auer R, Poulin EC, Mamazza J, Watters J, Fung-Kee-Fung M, Boushey RP, Pelletier JS, de Gara CJ, White J, Ghosh S, Schiller D, Drolet S, Paolucci EO, Heine J, Buie WD, Maclean AR, Barnes A, Liang S, Auer R, Moloo H, Mamazza J, Poulin EC, Boushey RP, Klevan AE, Dalvi AA, Ramsay JA, Stephen WJ, Nhan C, Driman DK, Raby M, Smith AJ, Hunter A, Srigley J, McLeod RS, Zolfaghari S, Auer R, Moloo H, Mamazza J, Friedlich M, Poulin EC, Stern HS, Boushey RP, Scheer AS, Boushey RP, Liang S, Doucette S, O'Connor AM, and Moher D

Published
2010

20. Abstracts of presentations to the Annual Meetings of the Canadian Association of General Surgeons Canadian Association of Thoracic Surgeons Canadian Hepato-Pancreato-Biliary Society Canadian Society of Surgical Oncology Canadian Society of Colon and Rectal Surgeons: Victoria, BC Sept. 10-13, 2009.

Author

Nenshi R, Kennedy E, Baxter NN, Saskin R, Sutradhar R, Urbach DR, Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM, Krajewski SA, Brown CJ, Hur C, McCrea PH, Mitchell A, Porter G, Grushka J, Razek T, Khwaja K, Fata P, Martel G, Moloo H, Picciano G, Boushey RP, Poulin EC, Mamazza J, Haas B, Xiong W, Brennan-Barnes M, Gomez D, Nathens AB, Yang I, Forbes SS, Stephen WJ, Loeb M, Smith R, Christoffersen EP, McLean RF, Westerholm J, Garcia-Osogobio S, Farrokhyar F, Cadeddu M, Anvari M, Ponton-Carss A, Hutchison C, Violato C, Segedi M, Mittleman M, Fisman D, Kinlin L, Rousseau M, Saleh W, Ferri LE, Feldman LS, Stanbridge DD, Mayrand S, Fried GM, Pandya A, Gagliardi A, Nathens A, Ahmed N, Tran T, Demyttenaere SV, Polyhronopoulos G, Seguin C, Artho GP, Kaneva P, Fried GM, Feldman LS, Demyttenaere SV, Bergman S, Anderson J, Mikami DJ, Melvin WS, Racz JM, Dubois L, Katchky A, Wall WJ, Faryniuk A, Hochman D, Clarkson CA, Rubiano AM, Clarkson CA, Boone D, Ball CG, Dixon E, Kirkpatrick AW, Sutherland FR, Feliciano DV, Wyrzykowski AD, Nicholas JM, Dente CJ, Ball CG, Feliciano DV, Ullah SM, McAlister VC, Malik S, Ramsey D, Pooler S, Teague B, Misra M, Cadeddu M, Anvari M, Kaminsky M, Vergis A, Gillman LM, Gillman LM, Vergis A, Altaf A, Ellsmere J, Bonjer HJ, Klassen D, Orzech N, Palter V, Aggarwal R, Okrainec A, Grantcharov TP, Ghaderi I, Feldman LS, Sroka G, Kaneva PA, Fried GM, Shlomovitz E, Reznick RK, Kucharczyk W, Lee L, Iqbal S, Barayan H, Lu Y, Fata P, Razek T, Khwaja K, Boora PS, White JS, Vogt KN, Charyk-Stewart T, Minuk L, Eckert K, Chin-Yee I, Gray D, Parry N, Humphrey RJ, Bütter A, Schmidt J, Grieci T, Gagnon R, Han V, Duhaime S, Pitt DF, Palter V, Orzech N, Aggarwal R, Okrainec A, Grantcharov TP, Dubois L, Vogt KN, Davies W, Schlachta CM, Shi X, Birch DW, Gu Y, Moser MA, Swanson TW, Schaeffer DF, Tang BQ, Rusnak CH, Amson BJ, Vogt KN, Dubois L, Hobbs A, Etemad-Rezai R, Schlachta CM, Claydon E, McAlister V, Grushka J, Sur W, Laberge JM, Tchervenkov J, Bell L, Flageole H, Labidi S, Gagné JP, Gowing R, Kahnamoui K, McAlister CC, Marble A, Coughlin S, Karanicolas P, Emmerton-Coughlin H, Kanbur B, Kanbur S, Colquhoun P, Trottier DC, Doucette S, Huynh H, Soto CM, Poulin EC, Mamazza J, Boushey RP, Jamal MH, Rousseau M, Meterissian S, Snell L, Racz JM, Davies E, Aminazadeh N, Farrokhyar F, Reid S, Naeeni A, Naeeni M, Kashfi A, Kahnamoui K, Martin K, Weir M, Taylor B, Martin KM, Girotti MJ, Parry NG, Hanna WC, Fraser S, Weissglas I, Ghitulescu G, Bilek A, Marek J, Galatas C, Bergman S, Chiu CG, Nguyen NH, Bloom SW, Wiebe S, Klassen D, Bonjer J, Lawlor D, Plowman J, Ransom T, Vallis M, Ellsmere J, Menezes AC, Karmali S, Birch DW, Forbes SS, Eskicioglu C, Brenneman FD, McLeod RS, Fraser SA, Bergman S, Garzon J, Gomez D, Lawless B, Haas B, Nathens AB, Lumb KJ, Harkness L, Williamson J, Charyk-Stewart T, Gray D, Malthaner RA, Van Koughnett JA, Vogt KN, Gray DK, Parry NG, Teague B, Cadeddu M, Anvari M, Misra M, Pooler S, Malik S, Swain P, Chackungal S, Vogt KN, Yoshy C, Etemad-Rezai R, Cunningham I, Dubois L, Schlachta CM, Scott L, Vinden C, Okrainec A, Henao O, Azzie G, Deen S, Hameed M, Ramirez V, Veillette C, Bray P, Jewett M, Okrainec A, Pagliarello G, Brenneman F, Buczkowski A, Nathens A, Razek T, Widder S, Anderson I, Klassen D, Saadia R, Johner A, Hameed SM, Qureshi AP, Vergis A, Jimenez CM, Green J, Pryor AD, Schlachta CM, Okrainec A, Perri MT, Trejos AL, Naish MD, Patel RV, Malthaner RA, Stanger J, Stewart K, Yasui Y, Cass C, Damaraju S, Graham K, Bharadwaj S, Srinathan S, Tan L, Unruh H, Finley C, Miller L, Ferri LE, Urbach DR, Darling G, Spicer J, Ergun S, McDonald B, Rousseau M, Kaneva P, Ferri LE, Spicer J, Andalib A, Benay C, Rousseau M, Kushner Y, Marcus V, Ferri LE, Hunt I, Gazala S, Razzak R, Chuck A, Valji A, Stewart K, Tsuyuki R, Bédard ELR, Bottoni DA, Campbell G, Malthaner RA, Rousseau M, Guevremont P, Chasen M, Spicer J, Eckert E, Alcindor T, Ades S, Ferri LE, McGory R, Nagpal D, Fortin D, Inculet RI, Malthaner RA, Ko M, Shargall Y, Compeau C, Razzak R, Gazala S, Hunt I, Veenstra J, Valji A, Stewart K, Bédard ELR, Davis PJ, Mancuso M, Mujoomdar AA, Gazala S, Bédard ELR, Lee L, Spicer J, Robineau C, Sirois C, Mulder D, Ferri LE, Cools-Lartigue J, Chang SY, Mayrand S, Marcus V, Fried GM, Ferri LE, Perry T, Hunt I, Allegretto M, Maguire C, Abele J, Williams D, Stewart K, Bédard ELR, Grover HS, Basi S, Chiasson P, Basi S, Gregory W, Irshad K, Schieman C, MacGregor JH, Kelly E, Gelfand G, Graham AJ, McFadden SP, Grondin SC, Croome KP, Chudzinski R, Hanto DW, Jamal MH, Doi SA, Barkun JS, Wong SL, Kwan AHL, Yang S, Law C, Luo Y, Spiers J, Forse A, Taylor W, Apriasz I, Mysliwiec B, Sarin N, Gregor J, Moulton CE, McLeod RS, Barnett H, Nhan C, Gallinger S, Demyttenaere SV, Nau P, Muscarella P, Melvin WS, Ellison EC, Wiseman SM, Melck AL, Davidge KM, Eskicioglu C, Lipa J, Ferguson P, Swallow CJ, Wright FC, Edwards JP, Kelly EJ, Lin Y, Lenders T, Ghali WA, Graham A, Francescutti V, Farrokhyar F, Tozer R, Heller B, Lovrics P, Jansz G, Kahnamoui K, Spiegle G, Schmocker S, Huang H, Victor C, Law C, Kennedy ED, McCart JA, Aslani N, Swanson T, Kennecke H, Woods R, Davis N, Klevan AE, Ramsay JA, Stephen WJ, Smith M, Plourde M, Johnson PM, Yaffe P, Walsh M, Hoskin D, Huynh HP, Trottier DC, Soto C, Auer R, Poulin EC, Mamazza J, Boushey RP, Moloo H, Huynh HP, Trottier DC, Soto C, Moloo H, Poulin EC, Mamazza J, Boushey RP, Nhan C, Driman DK, Smith AJ, Hunter A, McLeod RS, Eskicioglu C, Fenech DS, Victor C, McLeod RS, Trottier DC, Huynh H, Sabri E, Soto C, Scheer A, Zolfaghari S, Moloo H, Mamazza J, Poulin EC, Boushey RP, Hallet J, Guénette-Lemieux M, Bouchard A, Grégoire RC, Thibault C, Dionne G, Côté F, Langis P, Gagné JP, Raval MJ, Phang PT, Brown CJ, Kuzmanovic A, Planting A, Raval MJ, Phang PT, Brown CJ, Huynh HP, Trottier DC, Moloo H, Poulin EC, Mamazza J, Friedlich M, Stern HS, Boushey RP, Tang BQ, Moloo H, Bleier J, Goldberg SM, Alsharif J, Martel G, Bouchard A, Sabri E, Ramsay CR, Mamazza J, Poulin EC, Boushey RP, Richardson D, Porter G, Johnson P, Al-Sukhni E, Ridgway PF, O'Connor B, McLeod RS, Swallow CJ, Forbes SS, Urbach DR, Sutradhar R, Paszat L, Rabeneck L, Baxter NN, Chung W, Ko D, Sun C, Brown CJ, Raval M, Phang PT, Pao JS, Woods R, Raval MJ, Phang PT, Brown CJ, Power A, Francescutti V, Ramsey D, Kelly S, Stephen W, Simunovic M, Coates A, Goldsmith CH, Thabane L, Reeson D, Smith AJ, McLeod RS, DeNardi F, Whelan TJ, Levine MN, Al-Khayal KA, Buie WD, Wallace L, Sigalet D, Eskicioglu C, Gagliardi A, Fenech DS, Victor C, and McLeod RS

Published
2009

21. Are there advantages to robotic-assisted surgery over laparoscopy from the surgeon's perspective?

Author

Van Koughnett JA, Jayaraman S, Eagleson R, Quan D, van Wynsberghe A, and Schlachta CM

Abstract

The advantages of a robotic approach are often difficult to quantify for surgical procedures that can be performed laparoscopically. Using a novel subjective rating scale, this study demonstrates a methodology to measure surgeon assessment of ease of use, comparing complex operations performed robotically and laparoscopically. A subjective assessment scale for robotic surgery was developed that included 13 task-related factors assessing operative challenges and ease of use. As part of a larger study comparing outcomes of laparoscopic and robotic biliary-enteric anastomosis, a surgeon performing 20 choledochojejunal anastomoses in an ex vivo pig model completed this scale after each procedure. Ten anastomoses were performed laparoscopically and ten using da Vinci robot assistance. Overall difficulty was also assessed using a 10-cm visual analog scale. Robotic surgery was associated with superior ease to laparoscopy in 8 of the 13 factors, including image quality, depth perception, comfort, eye fatigue, dexterity, precision of motion, speed of motion, and range of motion. The visual analog scale also showed a significant benefit in overall ease of the robotic over laparoscopic procedure. Nonsignificant trends favoring robotics were seen with fluidity of motion and equipment setup. Based on these results this study suggest that surgeon ease of use may be quantified using this assessment scale and that robot assistance may be advantageous over laparoscopy when performing complex surgical tasks in an ex vivo model from the surgeon's perspective.

Published
2009
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