The Tumor Immune Microenvironment Drives Survival Outcomes and Therapeutic Response in an Integrated Molecular Analysis of Gastric Adenocarcinoma.

Purpose: We performed an integrated analysis of molecular classification systems proposed by The Cancer Genome Atlas (TCGA), the Asian Cancer Research Group (ACRG), and the tumor microenvironment (TME) score to identify which classification scheme(s) are most promising to pursue in subsequent translational investigations.

Experimental Design: Supervised machine learning classifiers were created using 10-fold nested cross-validation for TCGA, ACRG, and TME subtypes and applied to 2,202 patients with gastric cancer from 11 separate publicly available datasets. Overall survival was assessed with a multivariable Cox proportional hazards model.

Examining the equity and diversity characteristics of academic general surgeons hired in Canada.

Background: Job competition and underemployment among surgeons emphasize the importance of equitable hiring practices. The purpose of this study was to describe some of the demographic characteristics of academic general surgeons and to evaluate the gender and visible minority (VM) status of those recently hired.

Methods: Demographic information about academic general surgeons across Canada including gender, VM status, practice location and graduate degree status was collected.

Characterizing Canadian rural general surgeons: trends over time and 10-year replacement needs.

Background: Recruiting residents to practise rurally begins with an accurate characterization of rural surgeons. We sought to identify and analyze demographic trends among rural surgeons in Canada and to predict the rural workforce requirements for the next decade.

Methods: In this retrospective observational study, we assessed the demographic and practice characteristics of rural general surgeons in Canada, defined as surgeons working in cities with a population of 100 000 or less.

A prospective Canadian gastroesophageal cancer database: What have we learned?

Background: Minimal literature exists on outcomes for Canadian patients with gastroesophageal adenocarcinoma (GEA). The objective of our study was to establish a prospective clinical database to evaluate demographic characteristics, presentation and outcomes of patients with GEA.

Methods: Patients diagnosed with GEA were recruited from Jan.

Duodenal-jejunal bypass liners are superior to optimal medical management in ameliorating metabolic dysfunction: A systematic review and meta-analysis.

This systematic review and meta-analysis evaluates metabolic and anthropometric outcomes of duodenal-jejunal bypass liners (DJBLs) compared to optimal medical management for the treatment of obesity and its associated metabolic complications. A systematic search of MEDLINE, Embase, Scopus, and Web of Science databases was conducted. Studies were reviewed and data were extracted following the PRISMA guidelines.

Canadian Pediatric Surgeon Workforce: Characterization of Training, Trends Over Time, and 10-year Model for Pediatric Surgery Need.

Background: Graduate and fellowship training trends for Canadian pediatric surgeons remain uncharacterized. Similarly, updated workforce planning for pediatric surgeons is required. We aimed to characterize graduate degree and fellowship trends for Canadian pediatric surgeons, with modelling to inform workforce planning.

Trends in types of graduate degrees and research output for academic general surgeons in Canada.

The proportion of general surgeons with graduate degrees in Canada is increasing. We sought to evaluate the types of graduate degree held by surgeons in Canada, and whether differences in publication capacity exist. We evaluated all general surgeons working at English-speaking Canadian academic hospitals to determine the types of degrees achieved, changes over time and research output associated with each degree.

Murine and Human Gastric Tissue Establishes Organoids after 48 Hours of Cold Ischemia Time during Shipment.

An inadequate supply of fresh tissue is a major limitation of three-dimensional patient-derived gastric organoid research. We propose that tissue procurement for organoid culture could be increased by developing a cold storage shipment protocol for fresh surgical tissues. Sixty stomach specimens from C57BL/6J mice were resected, of which forty-five were stored in Hank's Balanced Salt (HBSS), University of Wisconsin (UW), or Histidine-Tryptophan-Ketoglutarate (HTK) solutions for subsequent organoid culture.

Factors Associated With Resident Research Success: An Analysis of Canadian General Surgery Trainees.

Objective: Better understanding the research productivity of Canadian general surgery residents and factors associated with success would provide a valuable reference and help inform actions to enable success. We aimed to characterize the research productivity of Canadian general surgery residents and to evaluate factors associated with residents' research quantity and impact.

Design: A cross-sectional, observational study was performed using publicly available data evaluating Canadian General Surgery resident research productivity.

Opioid prescribing practices following bariatric surgery: a systematic review and pooled proportion meta-analysis.

Introduction: A paucity of literature exists regarding current opioid prescribing and use following bariatric surgery. We aimed to characterize opioid prescribing practices and use following bariatric surgery to inform future studies and optimized prescribing practices.

Methods And Procedure: We performed a systematic review of Ovid MEDLINE, Ovid Embase, Scopus, Web of Science Core Collection, and Cochrane Library (via WILEY) on August 20, 2021.

Association between academic degrees and research productivity: an assessment of Canadian academic general surgeons.

Background: For academic hiring committees and surgical trainees, the benefits of a graduate degree are unclear. We sought to identify if graduate degrees or professorship status were associated with increased research productivity among Canadian academic surgeons.

Methods: We included general surgeons from the largest hospitals associated with accredited residency programs.

New persistent opioid use after bariatric surgery: a systematic review and pooled proportion meta-analysis.

Introduction: Increasing evidence suggests surgical patients are at risk for developing new, persistent opioid use (NPOU) following surgery. This risk may be heightened for patients undergoing bariatric surgery. Few studies have evaluated this important long-term outcome and little is known about the rate of NPOU, or factors associated with NPOU for bariatric surgery patients.

The Impact of Metabolic and Bariatric Surgeon Status on Outcomes After Bariatric Surgery: a Retrospective Cohort Study Using the MBSAQIP Database.

Purpose: Differences between complication rates of bariatric surgeries performed by general surgeons (GS) versus those performed by metabolic and bariatric surgeons (MBS) are poorly understood.

Methods: We analyzed the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database focusing on RYGB and SG procedures between 2016 and 2019. Our primary objective was to evaluate trends in the number of bariatric procedures performed by GS and MBS.

Surgical outcomes and quality of life following exercise-based prehabilitation for hepato-pancreatico-biliary surgery: A systematic review and meta-analysis.

Background: Hepato-pancreatico-biliary (HPB) patients experience significant risk of preoperative frailty. Studies assessing preventative prehabilitation in HPB populations are limited. This systematic review and meta-analysis evaluates outcomes for HPB patients treated with exercise prehabilitation.

MRI monitoring of transplanted neonatal porcine islets labeled with polyvinylpyrrolidone-coated superparamagnetic iron oxide nanoparticles in a mouse model.

Islet transplantation is a potential treatment option for certain patients with type 1 diabetes; however, it still faces barriers to widespread use, including the lack of tools to monitor islet grafts post-transplantation. This study investigates whether labeling neonatal porcine islets (NPI) with polyvinylpyrrolidone-coated superparamagnetic iron oxide nanoparticles (PVP-SPIO) affects their function, and whether this nanoparticle can be utilized to monitor NPI xenografts with magnetic resonance imaging (MRI) in a mouse model. In vitro, PVP-SPIO-labeled NPI in an agarose gel was visualized clearly by MRI.

How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer? An observational study.

Purpose: Rectal bleeding is a common symptom of colorectal cancer. In this paper, we describe and evaluate the operation of a central access and triage system for patients with rectal bleeding, which uses a "high-risk"/ "low-risk" designation based on the referring doctor's subjective designation and a 10-item symptom checklist.

Methods: A total of 1846 patients, referred between February 1, 2016, and December 31, 2018, were included.

Five Years of MBSAQIP Data: Characteristics, Outcomes, and Trends for Patients with Super-obesity.

Purpose: Incidence of super obesity (SO; BMI ≥ 50 kg/m) is growing rapidly and confers worse metabolic complications than non-SO (BMI 30-50 kg/m). We aim to characterize bariatric surgery patients with SO, their postoperative complications, and treatment trends over the last 5 years in hopes of informing SO-specific treatment protocols.

Materials And Methods: The MBSAQIP database was analyzed, and two cohorts were compared, those with SO and non-SO.

Intraoperative fluorescence imaging with indocyanine green in hepatic resection for malignancy: a systematic review and meta-analysis of diagnostic test accuracy studies.

Background: Fluorescence imaging during hepatic resection has the potential to identify additional malignant tumors, increasing the chance for complete tumor resection. Indocyanine green (ICG) is an FDA approved, fluorescent dye used in a variety of surgical procedures. The objective of this study was to define the sensitivity of intraoperative ICG fluorescent imaging in the detection of hepatic malignancy in adult patients during hepatic resection, which was accomplished by performing a systematic review and meta-analysis.

A Shorter Circular Stapler Height at the Gastrojejunostomy during a Roux-En-Y Gastric Bypass Results in Less Strictures and Bleeding Complications.

The laparoscopic Roux-en-Y gastric bypass (LRYGB) is prone to a number of complications, most notably at the gastrojejunostomy (GJ) staple line. The circular stapler technique is a common method used to create the GJ anastomosis. Although recent studies have shown a decreased rate of anastomotic strictures with shorter stapler heights, the optimal circular stapler height to use remains controversial.

Assessing the accuracy of algorithm-derived cardiorespiratory fitness in surgical patients: a prospective cohort study.

Purpose: To determine if a non-exercise algorithm-derived assessment of cardiorespiratory fitness (CRF) accurately predicted estimated values obtained using a six-minute walk test (CRF) and the Duke Activity Status Index (CRF).

Methods: Following research ethics board approval, an observational cohort study was conducted in selected, consenting patients undergoing elective surgery. Participants completed questionnaires assessing their self-reported exercise capacity.