Canadian Journal of Surgery (CJS)

Preoperative PPI use was associated with higher rates of pneumonia and lower rates of gastrointestinal bleeding. Research Association between preoperative proton pump inhibitor use and postoperative infections and renal complications following major elective surgery Dubois et al. Can J Surg July 15, 2025 68 (4) E305-E312; DOI: https://doi.org/10.1503/cjs.010224

PPI use and complications following major elective surgery:
Preoperative PPI use was associated with higher rates of pneumonia and lower rates of gastrointestinal bleeding.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.010224

Over the last 25 years, the trajectory of Canadian plastic surgery literature has been characterized by continuous expansion while maintaining high quality. Research A 25-year retrospective of Canadian plastic surgery research and its influence: a bibliometric study Guerra Ordaz et al. Can J Surg July 15, 2025 68 (4) E296-E304; DOI: https://doi.org/10.1503/cjs.012024

A 25-year retrospective of Canadian plastic surgery research:
Over the last 25 years, the trajectory has been characterized by continuous expansion while maintaining high quality.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.012024

This study's findings suggest that pulmonary thrombosis immediately following trauma is a distinct clinical entity from pulmonary emboli that originate from DVT in the lower extremities. Research Traumatic primary pulmonary thrombosis: injury and treatment patterns of a distinct clinical entity Momic et al. Can J Surg July 15, 2025 68 (4) E289-E295; DOI: https://doi.org/10.1503/cjs.007124

Traumatic primary pulmonary thrombosis: injury and treatment patterns of a distinct clinical entity.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.007124

Volume 68, Issue 4. Read the latest on - Preoperative PPI use - Traumatic primary pulmonary thrombosis - Canadian plastic surgery research. Image: Omeprazole (a common proton pump inhibitor) pills spilling from prescription bottle into the palm of a hand.

PPI use and complications following major elective surgery.

New articles on preoperative PPI use, traumatic primary pulmonary thrombosis, and Canadian plastic surgery research.
➡️ www.canjsurg.ca/content/68/4

E181, Campbell Roxburgh at Queen's University. Episode 181 of the Cold Steel Podcast features Campbell Roxburgh discussing the development of robotic surgery in Scotland. Graphic includes podcast title, episode number, and an illustration of headphones.

On this episode of #ColdSteel, Campbell Roxburgh talks about the development of robotic surgery in Scotland, and the deliberate, systematic approach to introducing a new technology adopted by the NHS.
➡️https://www.canjsurg.ca/podcasts

This scoping review found that tap water for colonoscopy irrigation may be a more sustainable, cheaper, and safe alternative to sterile water. Research Testing the precautionary principle: a scoping review comparing potable tap and sterile water for irrigation in colonoscopy Ahn et al. Can J Surg July 10, 2025 68 (4) E281-E288; DOI: https://doi.org/10.1503/cjs.012724

Potable tap vs. sterile water for colonoscopy irrigation:
This scoping review found that tap water may be a more sustainable, cheaper, and safe alternative to sterile water.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.012724

An ERAS protocol allows safe next-day discharge after LRYGB. Research Enhanced Recovery After Surgery and next-day discharge after laparoscopic Roux-en-Y gastric bypass Hardy et al. Can J Surg July 10, 2025 68 (4) E274-E280; DOI: https://doi.org/10.1503/cjs.012923

Next-day discharge after laparoscopic Roux-en-Y gastric bypass:
An ERAS protocol allows safe next-day discharge after LRYGB.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.012923

Volume 68, Issue 4. Read the latest on - Tap versus sterile water for colonoscopy irrigation. - Next-day discharge after LRYGB. Image: Close-up of a chrome faucet dispensing potable tap water.

Potable tap versus sterile water for colonoscopy irrigation

New articles on tap vs. sterile water for colonoscopy irrigation, and next-day discharge after LRYGB.
➡️ www.canjsurg.ca/content/68/4

The authors have undertaken an EBRS review of a study on the role of whole blood in trauma resuscitation. Discussions in Surgery Evidence Based Reviews in Surgery: a critical appraisal of whole blood resuscitation in injured patients Nolan et al. Can J Surg June 18, 2025 68 (3) E271-E273; DOI: https://doi.org/10.1503/cjs.009924

A critical appraisal of whole blood resuscitation in injured patients:
The authors have undertaken an EBRS review of a study on the role of whole blood in trauma resuscitation.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.009924

Reductions in opioid use were achieved at a Canadian outpatient sports orthopedic surgical centre after implementation of a multimodal opioid restriction protocol. Research Changes in opioid distribution and chronic opioid users following outpatient orthopedic surgery: a pre–post intervention study Hemstock et al. Can J Surg June 18, 2025 68 (3) E265-E270; DOI: https://doi.org/10.1503/cjs.000325

Opioids after outpatient orthopedic surgery:
Reductions in opioid use were achieved after implementation of a multimodal opioid restriction protocol.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.000325

Women surgeons are underrepresented on faculties at 16 of 17 institutions, with lower research output and less senior academic representation. Research: Gender representation in professorship and research productivity across all surgical specialties in Canadian academic institutions Tanya et al. Can J Surg June 18, 2025 68 (3) E253-E264; DOI: https://doi.org/10.1503/cjs.015723

Gender representation in surgical specialties in Canadian academic institutions.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.015723

Surgeon-directed high-intensity KT interventions were not associated with lower rates of local tumour recurrence after rectal cancer surgery in 2 Ontario regions. Research: High- versus low-intensity knowledge translation interventions for surgeons and rates of local tumour recurrence after rectal cancer surgery: an Ontario study Simunovic et al. Can J Surg June 18, 2025 68 (3) E245-E252; DOI: https://doi.org/10.1503/cjs.012424

Knowledge translation and local tumour recurrence after rectal cancer surgery.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.012424

Text: New articles on opioids, rectal cancer, gender representation, and whole blood resuscitation in Volume 68, Issue 3 of the CJS. Image: Illustration showing an open pain pill capsule, from which flow x-ray images showing pain points from various orthopedic injuries of the wrist, ankle, shoulder, knee, hip and spine.

Opioids after outpatient orthopedic surgery

New articles on opioids, rectal cancer, gender representation, and whole blood resuscitation.
➡️https://www.canjsurg.ca/content/68/3

Si un système guidé par l’IA recommande une intervention dont l’issue est défavo­rable, qui en assume la responsabilité?

Scalpels en silicium ou chirurgiens artificiels?
Si un système guidé par l’IA recommande une intervention dont l’issue est défavo­rable, qui en assume la responsabilité?
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.009625

If an AI-driven system suggests a course of action that leads to a negative outcome, who bears the responsibility?

Silicon scalpels or artificial surgeons?
If an AI-driven system suggests a course of action that leads to a negative outcome, who bears the responsibility?
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.009125

Radiation exposure is much higher closer to the fluoroscopy machine and decreases following an inverse-square law from the radiation source.

Intraoperative radiation exposure in the OR:
Radiation exposure is much higher closer to the fluoroscopy machine and decreases following an inverse-square law from the radiation source.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.003824

The authors found evidence in favour of the efficacy of rural procedural care at BC facilities; these findings illustrate the potential for high-quality rural care for low-acuity procedures in similar settings. Research. Rural surgical and obstetric facility-level outcomes for index procedures: a retrospective cohort study (2016–2021). Kornelsen et al. Can J Surg June 10, 2025 68 (3) E221-E234; DOI: https://doi.org/10.1503/cjs.003423

Rural surgical and obstetric facility-level outcomes for index procedures:
Evidence in favour of the efficacy of rural procedural care at BC facilities.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.003423

Text: New articles on radiation exposure, high-quality rural care, and AI in Volume 68, Issue 3 of the CJS. Image: Surgeon positioning the C-arm machine over the patient in the operating room.

Intraoperative radiation exposure in a level 1 trauma centre orthopedic operating room.

New articles on radiation exposure, high-quality rural care, and AI.
➡️https://www.canjsurg.ca/content/68/3

Announcement of Cold Steel Podcast milestone of 10,000 downloads. As well as ways to subscribe on iTunes, Spotify, or Stitchr. Graphic includes announcement and an illustration of a microphone.

Hosted by Associate Editor, Dr. Ameer Farooq, and Coeditor in Chief, Dr. Chad Ball, Cold Steel delivers the latest on research, education, and career planning in Canadian surgery. ➡️https://www.canjsurg.ca/podcasts

Compared with patients with low BMI, patients with high BMI recover more slowly after knee replacement but reach similar function by 12 months, supporting surgery candidacy for all. Research The effects of obesity on functional outcomes after total knee arthroplasty: a prospective cohort study. Athar et al. Can J Surg May 29, 2025 68 (3) E214-E220; DOI: https://doi.org/10.1503/cjs.008524

Effects of obesity on functional outcomes after total knee arthroplasty:
Compared with patients with low BMI, patients with high BMI recover more slowly but reach similar function by 12 months.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.008524

A thoughtful approach is crucial for surgeons and institutions caring for pregnant patients with EGS diseases; treatment should be similar to that in nonpregnant patients, with some important considerations and modifications. Review: Pregnant patients requiring emergency general surgery: a scoping review of diagnostic and management strategies. Skelhorne-Gross et al. Can J Surg May 29, 2025 68 (3) E190-E213; DOI: https://doi.org/10.1503/cjs.001124.

Emergency general surgery strategies for pregnant patients:
A thoughtful approach is crucial for surgeons and institutions caring for pregnant patients with EGS diseases.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.001124

Text: New articles on EGS strategies for pregnant patients, and the effects of obesity on functional outcomes after TKA in Volume 68, Issue 3 of the CJS. Image: Pregnant person in a hospital bed with a catheter in hand.

Pregnant patients requiring emergency general surgery: a scoping review.

New articles on EGS strategies for pregnant patients, and the effects of obesity on functional outcomes after total knee arthroplasty.
➡️https://www.canjsurg.ca/content/68/3

Emergence from anesthesia is an appropriate clinical anchor for the time to perform the SSC sign-out phase. Research: Anchoring the sign-out phase of the Surgical Safety Checklist to emergence from anesthesia: a proof-of-concept quality-improvement study. Page et al. Can J Surg May 21, 2025 68 (3) E182-E189; DOI: https://doi.org/10.1503/cjs.003324

Anchoring SSC sign-out to emergency from anesthesia:
Emergence from anesthesia is an appropriate clinical anchor for the time to perform the SSC sign-out phase.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.003324

Patients in the lean referral pathway had lower wait times for breast cancer surgery, highlighting the benefits of streamlined, coordinated care. Research: Wait times for breast cancer surgery in lean and traditional care pathways: a multi-group path analysis. Freeze et al. Can J Surg May 21, 2025 68 (3) E175-E181; DOI: https://doi.org/10.1503/cjs.005524

Wait times for breast cancer surgery in lean and traditional pathways:
Patients in the lean referral pathway had lower wait times for breast cancer surgery, highlighting the benefits of streamlined, coordinated care.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.005524

Bariatric surgery outcomes were similar for Indigenous and non-Indigenous patients, although Indigenous patients reported less weight loss satisfaction. Research Outcomes and experiences of Indigenous patients in Newfoundland and Labrador’s Bariatric Surgery Program: a pilot study. Hossain et al. Can J Surg May 21, 2025 68 (3) E169-E174; DOI: https://doi.org/10.1503/cjs.000125

Bariatric surgery outcomes of Indigenous patients:
Bariatric surgery outcomes were similar for Indigenous and non-Indigenous patients, although Indigenous patients reported less weight loss satisfaction.
➡️http://www.canjsurg.ca/lookup/doi/10.1503/cjs.000125

Text: New articles on wait times for breast cancer surgery, outcomes and experiences of Indigenous patients, and emergence from anesthesia in Volume 68, Issue 3 of the CJS. Image: Radiology technician operating control panel on a mammography machine, positioning the compression paddle against a patient’s chest wall.

Wait times for breast cancer surgery in lean and traditional care pathways: a multi-group path analysis.

New articles on wait times for breast cancer surgery, outcomes and experiences of Indigenous patients, and emergence from anesthesia.
➡️https://www.canjsurg.ca/content/68/3

Black and white portrait of Sir Andrew MacPhail

Join Dr. Vivian McAlister, a former editor-in-chief of the CJS, and the FCWM on May 29th for a virtual talk about Sir Andrew MacPhail, author of the first volume of “Official History of the Canadian Forces in the Great War 1914-19" published 100 years ago ➡️ friends-amis.org/latest/event...

The authors offer a road map for improving gender diversity in orthopedic surgery, based on survey results from Canadian women in orthopedic surgery, analyzed using a gender bias framework and an educational conceptual framework. Research. A roadmap for surgeon leaders in improving gender equity: educational strategies, implementation, and evaluative methods. Clark et al. Can J Surg April 17, 2025 68 (2) E150-159; DOI: https://doi.org/10.1503/cjs.006324

Improving gender equity in orthopedic surgery:
The authors offer a road map for improving gender diversity in orthopedic surgery.
➡️
www.canjsurg.ca/lookup/doi/1...

Implementation of simple, low-cost interventions targeted at improving discharge education can reduce unnecessary revisits after pediatric appendectomy. Research: A quality improvement project targeting postoperative hospital revisit rates after pediatric appendicitis. Walser et al. Can J Surg April 17, 2025 68 (2) E137-E149; DOI: https://doi.org/10.1503/cjs.009024

Postoperative hospital revisit rates after pediatric appendicitis:
Implementation of simple, low-cost interventions targeted at improving discharge education can reduce unnecessary revisits.
➡️
www.canjsurg.ca/lookup/doi/1...

Injuries from rentable e-scooters are increasing. Patients require investigations and further management, representing substantial burdens to patients and the health care system. Municipalities, rental companies, and riders are responsible for reducing associated injuries. Research: Electric scooter injury and trauma in Edmonton: a multicentre prospective and retrospective observational study. Bristow et al. Can J Surg April 17, 2025 68 (2) E160-168; DOI: https://doi.org/10.1503/cjs.004924

Electric scooter injury and trauma:
Injuries are increasing. Patients require investigations and further management, representing substantial burdens to patients and the health care system.
➡️
www.canjsurg.ca/lookup/doi/1...