Global Makeup of Cardiothoracic Surgeons as Represented by Our Major Societies and Associations.

Background: Prior efforts to capture the cardiothoracic surgery community rely on survey data with potentially biased or low response rates. Our goal is to better understand our community by assessing the membership directories from The Society of Thoracic Surgeons (STS), American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), and Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS).

Methods: Membership data were obtained from membership directories.

Lung hemorrhage in trauma: Technical tricks and tips.

At some point as the on-call trauma surgeon, you may need to operate on a bleeding lung. This concise review addresses preoperative and intraoperative considerations for traumatic lung injuries, including how to deal with specific findings at the time of surgery.

Synchronous colorectal liver metastases: a national survey of surgeon opinions on simultaneous resection and multidisciplinary cooperation.

Background: The management of patients with synchronous colorectal liver metastases (sCRLM) has evolved significantly (improved chemotherapy, hepatic surgery advancements, colonic stenting, consultation synergies). We sought to better understand surgeon viewpoints on optimal referral patterns and the delivery of simultaneous resections.

Methods: A 40 question on-line survey was offered to members of the Canadian surgical community.

Assessing resectability of colorectal liver metastases: How do different subspecialties interpret the same data?

Background: Multimodal treatment of colorectal liver metastases (CRLMs) relies on precise upfront assessment of resectability. Variability in the definition of resectable disease and the importance of early consultation by a liver surgeon have been reported. In this pilot study we investigated the initial resectability assessment and patterns of referral of patients with CRLMs.

Practice and attitudes regarding double gloving among staff surgeons and surgical trainees.

Background: Despite supporting evidence, many staff surgeons and surgical trainees do not routinely double glove. We performed a study to assess rates of and attitudes toward double gloving and the use of eye protection in the operating room.

Methods: We conducted an electronic survey among all staff surgeons and surgical trainees at 2 tertiary care centres in Alberta between September and November 2015.

Examples of dramatic failures and their effectiveness in modern surgical disciplines: can we learn from our mistakes?

Innovation can be variably defined, but when applied to healthcare is often considered to be the introduction of something new, whether an idea, method or device, into an unfilled void or needy environment. Despite the introduction of many positive surgical subspecialty altering concepts/devices however, epic failures are not uncommon. These failures can be dramatic in regards to both their human and economic costs.

One thousand consecutive in-hospital deaths following severe injury: Has the etiology of traumatic inpatient death changed in Canada?

A wide range of factors have traditionally led to early in-hospital death following severe injury. The primary goal of this commentary was to evaluate the causes of early posttraumatic inpatient deaths over an extended period. Although early posttraumatic in-hospital death remains multifactorial, severe traumatic brain injuries are the dominant cause and have increased in proportion over time.

Management of haemothoraces in blunt thoracic trauma: study protocol for a randomised controlled trial.

Introduction: Haemothorax following blunt thoracic trauma is a common source of morbidity and mortality. The optimal management of moderate to large haemothoraces has yet to be defined. Observational data have suggested that expectant management may be an appropriate strategy in stable patients.

Does increased prehospital time lead to a "trial of life" effect for patients with blunt trauma?

Background: Variance in prehospital time among severely injured blunt trauma patients is dependent upon numerous factors. Effects on subsequent mortality and trauma team activation (TTA) rates are also unclear. The primary aim of this study was to evaluate the relationship between prehospital time and mortality at level I trauma referral centers amongst critically blunt injured patients.

The adequacy of hepatopancreatobiliary training: How does operative exposure and perceived readiness in fellowship translate into subsequent practice?

Over the last 3 decades, expansion in the scope and complexity of hepatopancreatobiliary (HPB) surgery has resulted in significant improvements in postoperative outcomes. As a result, the importance of dedicated fellowship training for HPB surgery is now well established, and the definition of formal program requirements has been actively pursued by a collaboration of the 3 distinct accrediting bodies within North America. While major advances have been made in defining minimum case volume requirements, qualitative assessment of the operative experience remains challenging.

The efficacy of a novel saline/bipolar radiofrequency energy instrument for arresting ongoing solid and non-solid organ hemorrhage in a swine model.

Introduction: Ongoing hemorrhage is often life threatening and can be challenging to stop in critically injured patients. Traditional techniques for addressing this issue include high voltage cautery (Bovie), topical hemostatic application, and the delivery of ignited argon gas. The goal of this study was to evaluate the efficacy of a novel energy device for arresting ongoing bleeding from both solid and non-solid organs within a swine model.

Five things they don't teach you in medical school.

You graduate from medical school with dreams of beginning your residency, during which you will study and train within the specialty you love more than any other. While you may be book-smart at this point in your career, medical school does not teach you everything you need to know. During residency you will learn the didactic and technical requirements for your future staff job, but medical school won't explicitly address many of the crucial "dos and don'ts" of a successful 2- to 5-year postgraduate training voyage.

Temporal trends in the use of diagnostic imaging for inpatients with pancreatic conditions: How much ionizing radiation are we using?

Background: Low-dose ionizing radiation from medical imaging has been indirectly linked with subsequent cancer and increased costs. Computed tomography (CT) is the gold standard for defining pancreatic anatomy and complications. Our primary goal was to identify the temporal trends associated with diagnostic imaging for inpatients with pancreatic diseases.

Forecasting the impact of stereotactic ablative radiotherapy for early-stage lung cancer on the thoracic surgery workforce.

Objectives: To predict variation in thoracic surgery workforce requirements with the introduction of stereotactic ablative radiotherapy (SABR) for the treatment of early-stage non-small-cell lung cancer (NSCLC).

Methods: Using Canadian census microdata and the Canadian Community Health Survey, a microsimulation model representing the national population was developed. The demand component simulates the incidence of lung cancer, incorporating the impact of computed tomography (CT) screening for high-risk individuals (>30 pack-year smoking history; age 55-74 years).

Has the quality of reporting of randomized controlled trials in thoracic surgery improved?

Objectives: To evaluate the quality of reporting of randomized controlled trials (RCTs) in the thoracic surgery literature according to Consolidated Standard for Reporting of Trials (CONSORT) and to determine predictors of quality.

Methods: All RCTs published in four principal journals between 1998 and 2013 were identified in PubMed. Two independent reviewers assessed each trial using the CONSORT checklist (1996) with discrepancies resolved by a third reviewer.

The adequacy of Hepato-Pancreato-Biliary training: how closely do perceptions of fellows and programme directors align?

Background: Hepatopancreatobiliary fellowship programmes have recently undergone significant changes with regards to training standards, case-volume thresholds and multimodality educational platforms. The goals of this study were to compare the perspectives of fellows and programme directors (PDs) on perceptions of readiness to enter practice and identify core Hepato-Pancreato-Biliary (HPB) procedures that require increased emphasis during training.

Methods: This survey targeted PDs and trainees participating in the Fellowship Council/AHPBA pathway.