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Background: It is generally accepted that surgical training is associated with increased surgical duration. The purpose of this study was to determine the magnitude of this increase for common surgical [...]

Introduction Many surgeons describe feeling a bit out of practice when they return from a vacation. There have been no studies assessing the impact of surgeon vacation on patient outcomes. Methods We used administrative data from the province of Ontario to identify patients who underwent a coronary artery bypass grafting. Using a propensity score, we matched patients who underwent their procedure immediately after their surgeon returned from vacation of at least 7 days (n = 1,161) to patients who were not operated immediately before or after a vacation period (n = 2,138). Results There was no significant difference in patient mortality (odds ratio: 1.23, p = 0.52), length of operation (relative risk [RR]: 1.00 p = 0.58), or intensive care unit/hospital stay (RR: 0.97 p = 0.66/RR: 0.98 p = 0.54, respectively). Conclusion There was not a significant change in risk of death, operative length, or hospital stay after a surgeon vacation. [ABSTRACT FROM AUTHOR]

Aims The objective of this study was to measure the incidence of urinary tract infections (UTIs), urologic reconstruction/urinary diversion, and renal dysfunction after a traumatic spinal cord injury (TSCI). Methods Retrospective cohort study using administrative data from Ontario, Canada. All incident adult TSCI patients (2002-2013) admitted to a rehabilitation center were included. The impact of lesion level on each outcome was assessed. The rate of outcomes was further compared to an age and sex matched sample from the general population. Results A total of 2,023 incident TSCI patients were identified (median follow-up of 4.8 years). Most patients (73%) were male and median age was 50 years. Lesion level included cervical (39%), thoracolumbar (44%), and unknown (17%). The incidence of serious UTIs (requiring emergency room visit or hospital admission) was 40%. Thoracolumbar lesion TSCI patients had significantly greater risk of serious UTIs (HR 1.3, 95%CI 1.1-1.7, P < 0.01) compared to those with a cervical lesion. Urologic reconstruction/urinary diversion was carried out on 2.4% of patients. New onset renal dysfunction was identified in 4.2% (84) TSCI patients. The rate ratios for serious UTIs (10.59, 95%CI 8.71-12.89), urologic reconstruction/urinary diversion (6.48, 95%CI 3.07-13.68), and renal dysfunction (2.55, 95%CI 1.70-3.83) were significantly increased among TSCI patients compared to matched controls. Conclusions Urologic disease is still an important source of morbidity for contemporary TSCI patients, and is more common compared to the general population. Neurourol. Urodynam. 36:640-647, 2017. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective The incidence of cholecystectomy in the pediatric population has increased over the last 20 years but has not been described in a Canadian population. We conducted the first province-wide study to describe the incidence of cholecystectomy in children in Ontario. Study Design A population-based, retrospective cohort using administrative databases in Ontario, Canada, was conducted. We included patients less than 18 years of age who underwent cholecystectomy from 1993 to 2012. Trends in rates of cholecystectomy were assessed with the Cochrane-Armitage test. Results There were a total of 6040 pediatric cholecystectomies performed over the study period in Ontario. The mean age was 14.3 years, and 79.6% of patients were females. The crude incidence per 100,000 person-years increased from 8.8 to 13.0 (p < 0.001) from 1993 96–2009–12, respectively. The sex-specific incidence showed a larger increase in the female population from 14.7 to 21.1 per 100,000 person-years (p < 0.001). The vast majority (82%) of surgeries were performed in 13–17 year olds and were largely performed in the community (> 75%). Conclusions There has been a significant rise in the incidence of pediatric cholecystectomy in Ontario over the last 20 years. The majority of surgeries are performed in the community, and pediatricians will likely see an increase of gallbladder disease in practice. [ABSTRACT FROM AUTHOR]

Background/purpose: This study was designed to determine the volume, postoperative surgical outcomes and, if possible, the relationship between outcome and institutional / surgeon volume in neonates undergoing repair of esophageal atresia with tracheoesophageal fistula (EA-TEF) over the last 20years in Ontario., Methods: Using administrative databases, a population based cohort study of patients undergoing EA-TEF repair in Ontario between 1993 and 2012 was conducted., Results: 465 patients with the diagnosis of EA-TEF met inclusion criteria. The mean number of EA-TEF repairs per year per was 5.8. There was a significant difference in hospital annual volume between institutions (range 12.3-3.35: p<0.05). The average number of cases/surgeon for the last 10 study years ranged between 0.5 and 2 cases/year. Primary outcome revealed that repair of recurrent fistula or intestinal interposition was 5.3%, with no reportable difference between institutions. Secondary outcomes revealed that 45.6% underwent dilatation for esophageal strictures, and 19.8% underwent some type of drainage procedure of the chest. These rates were not significantly different between institutions., Conclusion: This study provides insight into the outcomes following EA-TEF repair in Ontario and the difficulty in determining surgeon or institution volume outcome relationships, as both primary and secondary outcome event rates are very low., Level of Evidence: 2., (Copyright © 2018. Published by Elsevier Inc.)