Opioid use patterns following discharge from elective colorectal surgery: a prospective cohort study.

Introduction: Opioid overprescription after colorectal surgery can lead to adverse events, persistent opioid use, and diversion of unused pills. This study aims to assess the extent to which opioids prescribed at discharge after elective colorectal surgery are consumed by patients.

Methods: This prospective cohort study included adult patients (≥ 18 yo) undergoing elective colorectal surgery at two academic hospitals in Montreal, Canada.

Association between patient activation and adherence to a colorectal enhanced recovery pathway: a prospective cohort study.

Background: Low adherence to enhanced recovery pathways (ERPs) may negatively affect postoperative outcomes. The objective of this study was to assess the extent to which patient activation (PA, i.e.

A cross sectional survey on burnout and career satisfaction in surgeons: a joint work from the SAGES quality, outcomes, and safety and reimaging the practice of surgery burnout task forces.

Introduction: The growth of surgeon burnout is of significant concern. As we work to reimagine the practice of surgery, an accurate understanding of the extent of surgeon burnout is essential. Our goal was to define the current prevalence of burnout and quality of life (QOL) among SAGES surgeons.

Patient perspective on adapting to bowel dysfunction after rectal cancer surgery.

Aim: Bowel dysfunction continues to be a clinically significant consequence of rectal cancer surgery, affecting quality of life. Rectal cancer patients value self-empowerment and adaptation to change to improve their quality of life in the context of bowel dysfunction. There are limited qualitative data addressing patients' perspectives on adapting to bowel dysfunction.

Decision-making preferences and regret in rectal cancer patients undergoing restorative proctectomy: A prospective cohort study.

Background: How patients make treatment choices in rectal cancer is poorly understood and may affect long-term regret and satisfaction. The objective of this study is to characterize decision-making preferences and their effect on decisional regret in patients undergoing restorative proctectomy for rectal cancer.

Methods: A prospective cohort study was conducted in a single academic specialist rectal cancer center from October 2018 to June 2022.

The joy of surgery: how gender influences surgeons' experiences.

Introduction: Burnout in medicine is an epidemic, and surgeons are not immune. Studies often focus on negative factors leading to burnout, with less emphasis on optimizing joy. The purpose of this study, conducted by the SAGES Reimagining the Practice of Surgery Task Force, was to explore how gender may influence surgeon well-being to better inform organizational change.

The joy of surgery: how surgeons experience joy, time, and support.

Background: Burnout is a crisis in medicine, and especially in surgery it has serious implications not only for physician well-being but also for patient outcomes. This study builds on previous SAGES Reimagining the Practice of Surgery Task Force work to better understand how organizations might intervene to increase the "joy in surgery."

Methods: This was a cross-sectional, descriptive study utilizing a REDCap survey with closed-ended questions for data collection across 5 domains: facilitators of joy, support for best work, time for work tasks, barriers to joy, and what they would do with more time.

How well do we measure the impact of bowel dysfunction on health-related quality of life after rectal cancer surgery?

Background: Rectal cancer surgery risks causing bowel dysfunction, which has an important impact on health-related quality of life. The validity of generic tools used to measure health-related quality of life after bowel dysfunction is unclear. This study aimed to determine the content validity of health-related quality-of-life measurement tools in rectal cancer.

Hypertension and Kidney Function After Living Kidney Donation.

Importance: Recent guidelines call for better evidence on health outcomes after living kidney donation.

Objective: To determine the risk of hypertension in normotensive adults who donated a kidney compared with nondonors of similar baseline health. Their rates of estimated glomerular filtration rate (eGFR) decline and risk of albuminuria were also compared.

A history of the McGill Department of Surgery: the first 100 years (1923-2023).

SummaryIn 1923, just over 100 years ago, Edward William Archibald was appointed the first chair of surgery in McGill University's Faculty of Medicine. This milestone provides an opportunity to reflect on where the department has come from and how it has progressed to the present day. Although the size, breadth, and diversity of the department members have changed notably over the century, the core values of innovative clinical care, research, and education established a century ago continue to this day.

"Doing well": Intraoperative entrustable professional activity assessments provided limited technical feedback.

Background: Entrustable Professional Activities (EPAs) allow for the assessment of specific, observable, essential tasks in medical education. Since being developed in non-surgical fields, EPA assessments have been implemented in surgery to explore intraoperative entrustment. However, assessment burden is a significant problem for faculty, and it is unknown whether EPA assessments enable formative technical feedback.

Effect of video-based self-reflection on intraoperative skills: A pilot randomized controlled trial.

Background: The value of video-based self-assessment in enhancing surgical skills is uncertain. This study investigates the feasibility and estimates sample size for a full-scale randomized controlled trial to evaluate the effectiveness of video-based self-assessment to improve surgical performance of laparoscopic cholecystectomy in trainees.

Methods: This parallel pilot randomized controlled trial included general surgery trainees performing supervised laparoscopic cholecystectomy randomized 1:1 to control (traditional intraoperative teaching) or intervention group (traditional teaching plus video-based self-assessment).

Predictive Factors for Successful Same-Day Discharge After Minimally Invasive Colectomy and Stoma Reversal.

Background: Same-day discharge after minimally invasive colorectal surgery is a safe, effective practice in specific patients that can enhance the efficiency of enhanced recovery pathways.

Objective: To identify predictive factors associated with success or failure of same-day discharge.

Design: Prospective cohort study from January 2020 to March 2023.

The impact of patient activation on the effectiveness of digital health remote post-discharge follow-up and same-day-discharge after elective colorectal surgery.

Background: Low patient activation (PA) is associated with worse postoperative outcomes, however, its impact on the effectiveness of digital health interventions is unknown. We sought to determine the impact of PA on the effectiveness of digital health application for remote post-discharge follow-up for patients undergoing elective colectomy.

Methods: Data analysis included a control cohort (CC) of patients undergoing elective colorectal surgery from 10/2017 to 04/2018 without the digital health intervention and a digital application cohort (DAC) that received a smart phone application for remote post-discharge follow-up from 03/2021 to 08/2022, including a subset of same-day discharge (SDD) patients.

Watchful waiting for large primary nonparasitic splenic cysts.

Background: Primary nonparasitic splenic cysts (NPSC) are typically diagnosed incidentally. The management of large (≥ 5 cm) asymptomatic cysts remains controversial; there is a lack of evidence guiding management. The purpose of this study was to describe the outcomes of nonoperative management of large NPSC.

The impact of restorative proctectomy versus permanent colostomy on health-related quality of life after rectal cancer surgery using the patient-generated index.

Background: The impact of bowel dysfunction versus colostomy on quality of life after rectal cancer surgery is poorly understood.

Background: To evaluate the quality of life after rectal cancer surgery in patients with colostomy versus restorative proctectomy.

Methods: A mixed-methods study measuring quality of life using the Patient-Generated Index, patients were asked to list up to 5 areas of their life affected by their surgery.

Predictors of post-discharge pain and satisfaction with pain management after laparoscopic bariatric surgery: a prospective cohort study.

Background: Pain management after bariatric surgery remains challenging given the risk for analgesia-related adverse events (e.g., opioid use disorder, marginal ulcers).

Impact of enhanced recovery pathways on patient-reported outcomes after abdominal surgery: a systematic review.

Introduction: Evidence supports that enhanced recovery pathways (ERPs) reduce length of stay and complications; however, these measures may not reflect the perspective of patients who are the main stakeholders in the recovery process. This systematic review aimed to appraise the evidence regarding the impact of ERPs on patient-reported outcomes (PROs) after abdominal surgery.

Methods: Five databases (Medline, Embase, Biosis, Cochrane, and Web of Science) were searched for randomized controlled trials (RCTs) addressing the impact of ERPs on PROs after abdominal surgery.

Prescription and consumption of opioids after bariatric surgery: a multicenter prospective cohort study.

Introduction: In the current opioid crisis, bariatric surgical patients are at increased risk of harms related to postoperative opioid overprescribing. This study aimed to assess the extent to which opioids prescribed at discharge after bariatric surgery are consumed by patients.

Methods: This multicenter prospective cohort study included adult patients (≥ 18yo) undergoing laparoscopic bariatric surgery.

Patients' experiences undergoing cancer surgery during the COVID-19 pandemic: a qualitative study.

Purpose: This study aimed to understand patients' experiences undergoing cancer surgery during the COVID-19 pandemic. In response to COVID-19, many elective cancer surgeries were delayed creating a massive backlog of cases. Patients' experiences with surgical delays may inform healthcare systems' responses to the backlog of cases and guide preparations for future healthcare emergencies.