Examining the transferability of colon and rectal operative experience on outcomes following laparoscopic rectal surgery.

Background: Laparoscopic rectal surgery is technically challenging and often low volume. Alternatively, colon resections utilize similar advanced laparoscopic skills and are more common but it is unknown whether this experience affects laparoscopic rectal surgery outcomes. The purpose of this paper is to determine the volume-outcome relationship between several colorectal procedures and laparoscopic rectal surgery outcomes.

Drivers of Inpatient Costs After Colorectal Surgery Within a Publicly Funded Healthcare System.

Background: The morbidity and mortality associated with colorectal resections are responsible for significant healthcare use. Identification of efficiencies is vital for decreasing healthcare cost in a resource-limited system.

Objective: The purpose of this study was to characterize the short-term cost associated with all colon and rectal resections.

Geographic variation in the provider of screening colonoscopy in Canada: a population-based cohort study.

Background: Screening colonoscopy for the detection of colorectal carcinoma is provided by several specialties. Few studies have assessed geographic variation in the delivery of this care. Our objective was to investigate how geographic and socioeconomic factors affect who provides screening colonoscopy in Canada.

Neighborhood Variation in the Utilization of Laparoscopy for the Treatment of Colon Cancer.

Background: The rates of laparoscopic colectomy for colon cancer have steadily increased since its inception. Laparoscopic colectomy currently accounts for a third of colectomy procedures in the United States, but little is known regarding the spatial pattern of the utilization of laparoscopy for colon cancer.

Objective: This study evaluated the utilization of laparoscopy for colon cancer at the neighborhood level in Ontario.

A comparison of 30-day versus 90-day proton pump inhibitor therapy in prevention of marginal ulcers after laparoscopic Roux-en-Y gastric bypass.

Background: Marginal ulceration is one of the most common complications after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Proton pump inhibitors (PPIs) are commonly administered to decrease the incidence of marginal ulcer development.

Objective: We examine the differential impact of employing a 30-day versus 90-day postoperative PPI regimen on the development of marginal ulceration after LRYGB.

Early clinical experience with the POEM procedure for achalasia.

Background: Per oral endoscopic myotomy (POEM) is a viable alternative to standard Heller myotomy for surgical treatment of achalasia. Outcomes from the United States, Europe and Asia have been reported. We sought to report data after the initiation of POEM in a Canadian centre.

An Internet-Based Collaborative Cancer Conference for Rectal Cancer Influenced Surgeon Treatment Recommendations.

Introduction: In many jurisdictions geographic and resource constraints are barriers to multidisciplinary cancer conference review of all patients undergoing cancer surgery. We piloted an internet-based collaborative cancer conference (I-CCC) for rectal cancer to overcome these barriers in the LHIN4 region of Ontario (population 1.4 million).

Quality improvement in colorectal cancer in local health integration network 4 (LHIN 4) project (QICC-L4): integrated knowledge translation in a large geographic region.

Background: Stakeholders suggest that integrating end users into the planning and execution of quality improvement interventions may more effectively close quality gaps. We tested if such an approach could improve the quality of colorectal cancer surgery in a large geographic region (i.e.

Uptake and patient outcomes of laparoscopic colon and rectal cancer surgery in a publicly funded system and following financial incentives.

Purpose: To assess patterns of uptake and outcomes of laparoscopic colon and rectal cancer surgery in Ontario, and the potential influence of surgical fee incentives instituted on October 1, 2005.

Methods: We used Ontario administrative databases from fiscal years 2002 to 2009. Study outcomes were uptake rates of laparoscopic surgery, hospital length of stay, 30-day operative mortality, cancer-specific survival, and overall survival.

Midterm outcomes of laparoscopic surgery for rectal cancer.

In this study, the authors examine midterm survival and recurrence after laparoscopic and open surgery for rectal cancer. This is a retrospective review of a prospective database for rectal cancer surgeries performed at the authors' institution, with follow-up data obtained through chart review. In all, 74 patients in this study had open surgery, and 93 had laparoscopic surgery.

A hinged metalloplastic anastomotic device: a novel method for choledochoduodenostomy.

Background: In biliary obstruction, the creation of a large-diameter permanent fistula between the bile duct and the duodenum would be attractive.

Objective: To invent, prototype, and test a new method of forming a biliary duodenal anastomosis.

Design: Survival and nonsurvival porcine model.

Laparoscopic surgery for colon cancer: a systematic review.

Introduction: Colorectal cancer is the second leading cause of cancer-related death in western countries. The objective of this systematic review was to show that laparoscopic-assisted colon resection for cancer is not inferior to open colectomy with respect to cancer survival and perioperative outcomes.

Method: We performed a comprehensive literature review.

Management of spleen injuries in the adult trauma population: a ten-year experience.

Background: Increasing awareness of the postoperative risks associated with splenectomies has led physicians and surgeons to use an alternative nonoperative strategy in handling traumatic spleen injuries. Our primary objective was to compare clinical outcomes between operative and nonoperative managements in adult patients with blunt splenic injuries. The secondary objective was to assess the changes in the patterns of managing splenic injuries in the past 10 years.

A minimally invasive approach to the treatment of aberrant splenic artery aneurysms: a report of two cases.

Symptomatic aneurysms of an aberrant splenic artery originating from the superior mesenteric artery are rare, with only five previous reports in the literature. The retropancreatic position renders their treatment more complex than aneurysms of orthotopic splenic arteries. Traditional treatment has been open surgical repair, with or without maintenance of flow through the splenic artery.

Minimally invasive adrenalectomy for pheochromocytoma during pregnancy.

Pheochromocytoma during pregnancy is a very rare condition; fewer than 200 cases have been reported in the literature. We present the case of a 24-year-old pregnant woman found to have a pheochromocytoma during investigation of abdominal pain. This is the second reported case of laparoscopic adrenalectomy for pheochromocytoma detected during pregnancy.

Laparoscopic excision of urachal anomalies: a review.

Technological advancements have refined laparoscopic surgery and expanded its application to include many disease processes and organs. As next-generation instruments become smaller (<5 mm), secondary benefits such as cosmesis, patient satisfaction, and decreased postoperative analgesic requirements are being realized. Urachal anomalies are rare, and their management is evolving from total radical open, to needlescopic ( View Article and Find Full Text PDF