Development Of General Surgery Research Articles

What is the diagnostic value of C-reactive protein for the prediction and the exclusion of postoperative infectious complication after colorectal surgery?

DOI: 10.1503/cjs.015414 The term “evidence-based medicine” was first coined by Sackett and colleagues as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”1 The key to practising evidencebased medicine is applying the best current knowledge to decisions in individual patients. Medical knowledge is continually and rapidly expanding. For clinicians to practise evidence-based medicine, they must have the skills to read and interpret the medical literature so that they can determine the validity, reliability, credibility and utility of individual articles. These skills are known as critical appraisal skills, and they require some knowledge of biostatistics, clinical epidemiology, decision analysis and economics, and clinical knowledge. Evidence Based Reviews in Surgery (EBRS) is a program jointly sponsored by the Canadian Association of General Surgeons (CAGS) and the American College of Surgeons (ACS). The primary objective of EBRS is to help practising surgeons improve their critical appraisal skills. During the academic year, 8 clinical articles are chosen for review and discussion. They are selected for their clinical relevance to general surgeons and because they cover a spectrum of issues im port ant to surgeons, including causation or risk factors for disease, natural hist ory or prognosis of disease, how to quantify disease, diagnostic tests, early diagnosis and the effectiveness of treatment. A methodological article guides the reader in critical appraisal of the clinical article. Methodological and clinical reviews of the article are performed by experts in the relevant areas and posted on the EBRS website, where they are archived indefinitely. In addition, a listserv allows participants to discuss the monthly article. Surgeons who participate in the monthly packages can obtain Royal College of Physicians and Surgeons of Canada Maintenance of Certification credits and/or continuing medical education credits for the current article only by reading the monthly articles, participating in the listserv discussion, reading the methodological and clinical reviews and completing the monthly online evaluation and multiple choice questions. We hope readers will find EBRS useful in improving their critical appraisal skills and in keeping abreast of new developments in general surgery. Four reviews are published in condensed versions in the Canadian Journal of Surgery and 4 are published in the Journal of the American College of Surgeons. For further information about EBRS, please refer to the CAGS or ACS websites. Questions and comments can be directed to the program administrator, Marg McKenzie, at mmckenzie@mtsinai.on.ca.

CAGS and ACS evidence based reviews in surgery. Is a diverting loop ileostomy and colonic lavage an alternative to colectomy for the treatment of severe Clostridium difficile-associated disease?

The term “evidence-based medicine” was first coined by Sackett and colleagues as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”1 The key to practising evidencebased medicine is applying the best current knowledge to decisions in individual patients. Medical knowledge is continually and rapidly expanding. For clinicians to practise evidence-based medicine, they must have the skills to read and interpret the medical literature so that they can determine the validity, reliability, credibility and utility of individual articles. These skills are known as critical appraisal skills, and they require some knowledge of biostatistics, clinical epidemiology, decision analysis and economics, and clinical knowledge. Evidence Based Reviews in Surgery (EBRS) is a program jointly sponsored by the Canadian Association of General Surgeons (CAGS) and the American College of Surgeons (ACS). The primary objective of EBRS is to help practising surgeons improve their critical appraisal skills. During the academic year, 8 clinical articles are chosen for review and discussion. They are selected for their clinical relevance to general surgeons and because they cover a spectrum of issues im -port ant to surgeons, including causation or risk factors for disease, natural history or prognosis of disease, how to quantify disease, diagnostic tests, early diagnosis and the effectiveness of treatment. A methodological article guides the reader in critical appraisal of the clinical article. Methodological and clinical reviews of the article are performed by experts in the relevant areas and posted on the EBRS website, where they are archived indefinitely. In addition, a listserv allows participants to discuss the monthly article. Surgeons who participate in the monthly packages can obtain Royal College of Physicians and Surgeons of Canada Maintenance of Certification credits and/or continuing medical education credits for the current article only by reading the monthly articles, participating in the listserv discussion, reading the methodological and clinical reviews and completing the monthly online evaluation and multiple choice questions. We hope readers will find EBRS useful in improving their critical appraisal skills and in keeping abreast of new developments in general surgery. Four reviews are published in condensed versions in the Canadian Journal of Surgery, 4 are published in the Journal of the American College of Surgeons and 4 are published in Diseases of the Colon and Rectum. For further information about EBRS, please refer to the CAGS or ACS websites. Questions and comments can be directed to the program administrator, Marg McKenzie, at mmckenzie@mtsinai.on.ca.

Some issues regarding the development of general surgery during the last half century.

As one of the first surgeons to perform pancreaticoduodenectomy in China in the middle of the last century, and with continuous clinical experience since then, I have witnessed various problematic events and continual changes in surgical procedures during their development, yet more profoundly, I see the flourishing stage that general surgery has gradually entered.

A new era for the development of general surgery

General surgery has been the clinical foundation for all of the branches of the surgical specialties. The scientific principles developed in general surgery have spread through the specialties as well. This is the basis for surgical mastery. The rapid development of information sciences brings great opportunities for further developments in general surgery. General surgeons will be challenged to learn how to incorporate these advances into their practice. Integrating other disciplines such as digital imaging will be required for general surgeons in the 21st century. General surgeons should not only understand the essence of traditional general surgery, but also be proficient in the usage of advanced diagnostic and therapeutic tools which will lead to promoting further developments in general surgery. Key words: General surgery; Surgeons; Information sciences

Surgical Education in China

A highly skilled surgical team relies on a standardized training system and the most important subject in the development of general surgery in China is to set up standardized education and training systems for surgeons. This article reviews the history of the training of residents, delineates the current situation and problems of residency training in general surgery, and discusses reform and future development of surgical training systems and assessment of competence in surgical practice, in order to put forward the solutions and countermeasures. China needs a large number of highly trained surgeons to improve its medical care system, and some fundamental changes of its residency training system, especially in the field of surgical education, have been made. All of the experts working in this area sum up the historical experience and apply the advanced experience of foreign countries as a reference to build up a surgical education system with Chinese characteristics to achieve a continuous, sound, and rapid development of surgical education in China.