This week on #ColdSteel, Paul Fedak speaks about what it means to pursue excellence and what it might cost us.
➡️https://www.canjsurg.ca/podcasts
Posts by Canadian Journal of Surgery (CJS)
Delays in health care are increasing in Canada, with wait time intervals a particular area of concern. Research: The growing burden of spine surgical wait times: a retrospective cohort study of longitudinal trends and impact on perioperative outcomes. Wang et al. Can J Surg March 31, 2026 69 (2) E164-E172; DOI: https://doi.org/10.1503/cjs.000625
Spine surgical wait times:
Delays in health care are increasing in Canada, with wait time intervals a particular area of concern..
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.000625
Surgeons who graduated more recently are emigrating from Canada to the US out of necessity, supporting the notion of graduates not having adequate opportunities in Canada. Research: Where are orthopedic surgery graduates practising? A critical look at the last 30 years in Ontario. Ndoja et al. Can J Surg March 31, 2026 69 (2) E155-E163; DOI: https://doi.org/10.1503/cjs.011525
Where are orthopedic surgery graduates practising?
Newer surgeons are emigrating to the US out of necessity, supporting the notion recent graduates do not have adequate opportunities in Canada.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.011525
The provincial shoulder database demonstrates the early stages of a registry, which contains useful, granular data. Research: Implementation of and findings from a regional shoulder replacement registry. Woodmass et al. Can J Surg March 31, 2026 69 (2) E137-E145; DOI: https://doi.org/10.1503/cjs.014624
A regional shoulder replacement registry:
The provincial shoulder database demonstrates the early stages of a registry, which contains useful, granular data.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.014624
A BMI of 45 or higher is a risk factor for re-revision, postoperative infection, and readmission rates after TKA an increase 90-day costs. Research: The effect of obesity on revision total knee arthroplasty: a retrospective cohort study. Nassereddine et al. Can J Surg March 31, 2026 69 (2) E146-E154; DOI: https://doi.org/10.1503/cjs.003525
Effect of obesity on RTKA:
A BMI of 45 or higher is a risk factor for re-revision, postoperative infection, and readmission rates after TKA an increase 90-day costs.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.003525
New articles the effect of obesity on revision total knee arthroplasty, a regional shoulder replacement registry, where ortho surgery grads are practising, and spine surgical wait times in Volume 69, Issue 2 of the CJS. Image: Three-dimensional illustration of a shoulder implant in an outline of a human skeleton.
The effect of obesity on revision total knee arthroplasty.
New articles also on a regional shoulder replacement registry, where ortho surgery grads are practising, spine surgical wait times.
➡️ www.canjsurg.ca/content/69/2
The ZMR taper stem demonstrated favourable functional outcomes for the management of Vancouver B2 and B3 periprosthetic femur fractures. Research Clinical outcomes of revision arthroplasty with a modular taper fluted titanium stem for the treatment of Vancouver B2 and B3 periprosthetic femur fractures Kubik et al. Can J Surg March 17, 2026 69 (2) E122-E129; DOI: https://doi.org/10.1503/cjs.011125
Revision arthroplasty with the ZMR taper stem demonstrated favourable functional outcomes for the management of Vancouver B2 and B3 periprosthetic femur fractures.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.011125
While most resident salaries met living wage benchmarks, some programs fell short, forcing residents to cover the gap. Research Comparison of resident salary and living wage in Canada: a cross-sectional study Yin et al. Can J Surg March 17, 2026 69 (2) E130-E136; DOI: https://doi.org/10.1503/cjs.013025
Comparison of resident salary and living wage in Canada: While most resident salaries met living wage benchmarks, some programs fell short, forcing residents to cover the gap.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.013025
Text: New articles on resident salaries, revision arthroplasty with a modular taper fluted titanium stem in Volume 69, Issue 2 of the CJS. Image: Female resident in her apartment paying bills.
Comparison of resident salary and living wage in Canada: a cross-sectional study.
New articles on resident salaries, revision arthroplasty with a modular taper fluted titanium stem.
➡️ www.canjsurg.ca/content/69/2
Damage-control laparotomy performed at rural hospitals before transfer to a trauma centre is not associated with higher morbidity or mortality, and collaboration between lead trauma hospitals and rural centres should be encouraged in select cases. Research. Reinforcing the role of rural trauma laparotomy Chaulk et al. Can J Surg March 3, 2026 69 (2) E108-E113; DOI: https://doi.org/10.1503/cjs.013325
Reinforcing the role of rural trauma laparotomy:
Collaboration between hospitals and rural centres should be encouraged in select cases.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.013325
Stimulant misuse is a relevant issue in the trauma population, associated with increased hospital length of stay, but no significant difference in mortality. Research. Stimulant drug misuse in patients presenting to level 1 trauma centres: a retrospective analysis of 80 000 patients in Canada and the United States. Cristofaro et al. Can J Surg March 3, 2026 69 (2) E114-E120; DOI: https://doi.org/10.1503/cjs.010024
Stimulant drug misuse in trauma patients:
A relevant issue in the trauma population, associated with increased hospital length of stay, but no significant difference in mortality.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.010024
CJS Volume 69 Issue 2. Read the latest on: stimulant drug misuse in trauma patients, rural trauma laparotomy. Image: 3,4-methylenedioxy-methamphetamine (MDMA) crystals.
Stimulant drug misuse in patients presenting to level 1 trauma centres: a retrospective analysis.
New articles on stimulant drug misuse in trauma patients, and rural trauma laparotomy.
➡️ www.canjsurg.ca/content/69/2
Cold Steel Podcast E187. Krista Goulding on pelvic sarcomas, 3D printing, and what patients really want. Graphic includes podcast title, episode number, and an illustration of headphones/microphone.
This week on #ColdSteel, in a “How I Built This” segment of the William Ersil Research day, we explored Dr. Krista Goulding’s career, pelvic sarcomas, 3D printing, and what patients really want.
➡️https://www.canjsurg.ca/podcasts
Nous risquons l’exode de toute une génération d’extraordinaires talents en devenir et de médecins aux compétences hors pair qui risquent de refuser d’exercer la profession au Québec dans les conditions contraignantes de la loi 83 et de la loi 2. Éditorial. Les médecins mis à mal par François Legault. Harvey. Can J Surg February 18, 2026 69 (1) E104-E105; DOI: https://doi.org/10.1503/cjs.003826
Les médecins mis à mal par François Legault:
Nous risquons l’exode de toute une génération d’extraordinaires talents en devenir qui risquent de refuser d’exercer la profession au Québec.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.003826
We risk a generational exodus where the brightest minds and most capable physicians are unwilling to practise in Quebec under constraints from Bill 83 and Bill 2. Editorial: Legault took aim at Quebec physicians. Harvey. Can J Surg February 18, 2026 69 (1) E102-E103; DOI: https://doi.org/10.1503/cjs.003126
Legault took aim at Quebec physicians:
We risk a generational exodus where the brightest minds are unwilling to practise in Quebec under constraints from Bill 83 and Bill 2.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.003126
Changing a small number of events affects the significance of results comparing carotid endarterectomy to carotid artery stenting. Research. Assessing the fragility index of randomized controlled trials on carotid artery stenosis: a systematic review. Liu et al. Can J Surg February 18, 2026 69 (1) E90-E96; DOI: https://doi.org/10.1503/cjs.008525
Fragility index of RCTs on carotid artery stenosis:
Changing a small number of events affects the significance of results comparing carotid endarterectomy to carotid artery stenting.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.008525
As key contributors to surgical emissions and as leaders in the OR, surgeons have an important role in addressing surgical sustainability and advocating for greener OR practices. Discussions in Surgery. Environmental sustainability in the operating room: perspectives and practice patterns of general surgeons in Canada. Ma et al. Can J Surg February 18, 2026 69 (1) E84-89; DOI: https://doi.org/10.1503/cjs.012325
Environmental sustainability in the OR:
Surgeons have an important role in addressing surgical sustainability and advocating for greener OR practices.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.012325
Adoption of a national guideline would empower trainees, promote inclusivity, and encourage more women to consider orthopedic surgery careers. Discussions in Surgery. Provincial agreements for pregnant and parenting orthopedic surgery residents: a call for a national residency guideline. Morrison et al. Can J Surg February 18, 2026 69 (1) E97-E101; DOI: https://doi.org/10.1503/cjs.015623
Provincial agreements for pregnant and parenting orthopedic surgery residents: a call for a national residency guideline.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.015623
CJS Volume 69 Issue 1. Read the latest on: pregnant and parenting ortho surgery residents, environmental sustainability in the OR, fragility index of RCTs, Quebec physicians. Image: Pregnant surgeon preparing for the operating room.
Provincial agreements for pregnant and parenting orthopedic surgery residents: a call for a national residency guideline.
New articles on environmental sustainability, fragility index of RCTs, and more.
➡️ www.canjsurg.ca/content/69/1
Surgical mortality among nonagenarian patients is nearly 3 times higher than among octogenarian patients; comprehensive geriatric assessment is essential before operating. Research. Surgical outcomes in nonagenarian versus octogenarian patients: a propensity-matched analysis with implications for shared decision-making. Kanani et al. Can J Surg February 4, 2026 69 (1) E71-E83; DOI: https://doi.org/10.1503/cjs.009525
Surgical outcomes:
Surgical mortality among nonagenarian patients is nearly 3 times higher than among octogenarian patients; comprehensive geriatric assessment is essential before operating.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.009525
The relocation of appropriate gynecologic procedures from the OR to an ambulatory setting provides quality care and improves access without increasing cost to the system. Commentary: The migration of hysteroscopy from the operating room to an ambulatory setting. Thiel et al. Can J Surg February 4, 2026 69 (1) E68-E70; DOI: https://doi.org/10.1503/cjs.008825
Hysteroscopies:
The relocation of appropriate gynecologic procedures from the OR to an ambulatory setting provides quality care and improves access without increasing cost to the system.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.008825
The poorer prognosis associated delayed or missing follow-up highlights the importance of respecting provincial guidelines for follow-up after incomplete colonoscopies. Research. The impact of incomplete colonoscopies: a single-centre retrospective study. Abdelli et al. Can J Surg February 4, 2026 69 (1) E59-E67; DOI: https://doi.org/10.1503/cjs.003425
Incomplete colonoscopies:
The poorer prognosis associated delayed or missing follow-up highlights the importance of respecting provincial guidelines for follow-up after incomplete colonoscopies.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.003425
CJS Volume 69 Issue 1. Read the latest on: Incomplete colonoscopies, Hysteroscopy in an ambulatory setting, Surgical outcomes in nonagenarians. Image: Doctor explaining colonoscopy results to patient using monitor images on screen.
The impact of incomplete colonoscopies: a single-centre retrospective study.
New articles on incomplete colonoscopies, hysteroscopies, and surgical outcomes in nonagenarians.
➡️ www.canjsurg.ca/content/69/1
Upper-extremity amputation has high health care costs exceeding controls, with implications for vascularized composite allotransplantation. Research: Health care costs of major upper-extremity amputations in Ontario: a retrospective matched-cohort analysis with considerations for transplantation. Duru et al. Can J Surg January 20, 2026 69 (1) E48-E58; DOI: https://doi.org/10.1503/cjs.000525
Health care costs of major upper-extremity amputations in Ontario:
High health care costs exceeding controls, with implications for vascularized composite allotransplantation.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.000525
Immigrant females with breast cancer in Ontario undergo immediate and delayed breast reconstruction less often than nonimmigrant females. Research: Reconstructive surgery and immigration status among females with breast cancer. Lovrics et al. Can J Surg January 20, 2026 69 (1) E38-E47; DOI: https://doi.org/10.1503/cjs.012324
Reconstructive surgery and immigration status:
Immigrant females with breast cancer in Ontario undergo immediate and delayed breast reconstruction less often than nonimmigrant females.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.012324
Read the latest on - Reconstructive surgery and immigration status - Costs of major upper-extremity amputations. Image: Surgical image showing breast reconstruction after mastectomy in a breast cancer patient with pale skin.
Reconstructive surgery and immigration status among females with breast cancer.
New articles on reconstructive surgery and immigration status, and costs of major upper-extremity amputations.
➡️ www.canjsurg.ca/content/69/1
There is a marked disparity in trauma-related mortality between Eeyou Istchee and the rest of Quebec, with motor vehicle collisions the leading cause of trauma death. Research - The burden of trauma in Eeyou Istchee (Cree territories, James Bay): epidemiology, transfers, and patient outcomes. Alsuwaidi et al. Can J Surg January 13, 2026 69 (1) E30-E36; DOI: https://doi.org/10.1503/cjs.011325.
The burden of trauma:
There is a marked disparity in trauma-related mortality between Eeyou Istchee and the rest of Quebec, with motor vehicle collisions the leading cause of trauma death.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.011325
Pneumonectomy remains a valuable therapeutic option when treating patients with non–small cell lung cancer with a curative intent with regard to their overall survival, but it remains a procedure with high perioperative morbidity and mortality. Research: Is pneumonectomy still relevant for non–small cell lung cancer? Long-term overall survival from a 15-year experience. Hache et al. Can J Surg January 13, 2026 69 (1) E22-E29; DOI: https://doi.org/10.1503/cjs.007524
Is pneumonectomy still relevant for non–small cell lung cancer? Long-term overall survival from a 15-year experience.
➡️https://www.canjsurg.ca/lookup/doi/10.1503/cjs.007524
CJS Volume 69 Issue 1. Read the latest on: pneumonectomy in patients with NSCLC, the burden of trauma in Eeyou Istchee. Image: Pneumonectomy model showing the anatomy of the lungs, with one lung removed.
Is pneumonectomy still relevant for NSCLC? Long-term overall survival from a 15-year experience.
New articles on pneumonectomy in patients with NSCLC and the burden of trauma in Eeyou Istchee.
➡️ www.canjsurg.ca/content/69/1
E186: Adnan Alseidi on surgical education. Graphic includes podcast title, episode number, and an illustration of headphones/microphone.
On episode 186 of #ColdSteel, Dr. Adnan Alseidi discusses surgical education. What are the phases of mastery? Should we really be aiming for that? And how do we create trust between attending and trainees?
➡️https://www.canjsurg.ca/podcasts