Introduction/Welcome
Surgery is recognized as an essential component of healthcare as it cures and/or relives the symptoms of many diseases and injuries. However, surgical procedures often represent an extensive trauma to the body with an immediate negative impact on patients’ health and function. While most patients undergoing surgery recover back to ‘normal’ within a few weeks after the procedure, many patients suffer postoperative complications that delay their recovery, and some may never resume their baseline level of health. In fact, surgical complications represent the most common adverse event in hospitalized patients and thus impose a major healthcare economic burden. With an estimated 312 million surgical procedures performed worldwide every year (approximately 2.5 million in Canada), the World Health Organization deems that improving the quality and safety of surgical care is a global public-health concern.
McGill is one of the world’s leading centers for research on strategies to measure and improve the outcomes of surgical patients. Our researchers cover a wide range of topics in this field, including preoperative preparation (i.e. prehabilitation), minimally invasive surgical techniques, use of care pathways to improve surgical recovery, and strategies to mitigate harms associated with surgical care (e.g. by developing non-addictive strategies to manage postoperative pain in response to the opioid crisis in North America). Our research also specializes in developing innovative ways to measures surgical outcomes from the perspective of patients, using state-of-the-art questionnaires to assess self-reported surgical recovery. This work capitalizes on an ongoing shift towards the use of digital platforms to capture patient-reported outcomes and integration of data into cutting-edge artificial intelligence networks. The latter will provide an exciting opportunity to support surgical decision making by filling a need of patients and caregivers who commonly seek information about recovery expectations (i.e. will the patient resume usual activities after surgery? how long it will take?).
The increasing need for robust research aimed to assess and improve the outcomes of surgical patients has created a demand for scientists and clinician-scientists who are skilled in the design, conduct, and critical appraisal of surgical outcomes research. To address this need, McGill recently created unique (thesis and non-thesis) graduate programs tailored to the training needs of future surgical outcomes researchers.
Featured researchers/principal investigators
Julio Fiore Jr, PT, MSc, PhD
(https://scholar.google.ca/citations?user=99oIwt0AAAAJ&hl=en)
julio.fiorejunior [at] mcgill.ca
Liane Feldman, MD, FRCSC, FACS
(https://scholar.google.ca/citations?hl=en&user=LW5utxMAAAAJ)
liane.feldman [at] mcgill.ca
Lawrence Lee, MD, FRCSC, FACS, MSc, PhD
(https://scholar.google.ca/citations?hl=en&user=pjkwh-4AAAAJ)
larry.lee [at] mcgill.ca
Selected publications (past 5 years)
Dumitra T, Ganescu O, Hu R, Fiore JF Jr, Kaneva P, Mayo N, Lee L, Liberman AS, Chaudhury P, Ferri L, Feldman LS. Association Between Patient Activation and Health Care Utilization After Thoracic and Abdominal Surgery. JAMA Surg 2020. Online ahead of print.
Balvardi S, Pecorelli N, Castelino T, Niculiseanu P, Alhashemi M, Liberman AS, Charlebois P, Stein B, Carli F, Mayo NE, Feldman LS, Fiore JF Jr. Impact of Facilitation of Early Mobilization on Postoperative Pulmonary Outcomes After Colorectal Surgery: A Randomized Controlled Trial. Ann Surg 2020. Online ahead of print.
Carli F, Bousquet-Dion G, Awasthi R, Elsherbini N, Liberman S, Boutros M, Stein B, Charlebois P, Ghitilescu G, MD, Morin N, Jagoe T, Scheede-Bergdahl C, Minnella EM, Fiore JF Jr. Multimodal Prehabilitation for Frail Patients Undergoing Resection of Colorectal Cancer. A Randomized Controlled Trial. JAMA Surg 2020: 155(3):233-42.
Karimian N, Kaneva P, Donatelli F, Stein B, Liberman AS, Charlebois P, Lee L, Fiore JF Jr, Carli F, Feldman LS. Simple versus complex preoperative carbohydrate drink to preserve perioperative insulin sensitivity in laparoscopic colectomy: a randomized controlled trial. Ann Surg 2020; 271(5):819-826.
Trépanier M, Minnella EM, Paradis T, Awasthi R, Kaneva P, Schwartzman K, Carli F, Fried GM, Feldman LS, Lee L. Improved Disease-free Survival After Prehabilitation for Colorectal Cancer Surgery. Ann Surg 2019;270(3):493-501.
Fiore JF Jr, Feldman LS. Tracking Postoperative Recovery-Making a Case for Smartphone Technology. JAMA Surg 2019. doi: 10.1001/jamasurg.2019.4703.
Lee L, Mata J, Droeser RA, Kaneva P, Liberman AS, Charlebois P, Stein B, Fried GM, Feldman LS. Incisional hernia after midline versus transverse specimen extraction incisions: a randomized trial in patients undergoing laparoscopic colectomy. Ann Surg 2018 Jul;268(1):41-47
Fiore JF Jr, Figueiredo S, Balvardi S, Lee L, Nauche B, Landry T, Mayo N, Feldman LS. How do we value postoperative recovery? A systematic review of the measurement properties of patient-reported outcomes after abdominal surgery. Ann Surg. 2018 Apr;267(4):656-669.
Berian JR, Ban K, Liu J, Sullivan CL, Ko CY, Thacker JK, Feldman LS. Association of an Enhanced Recovery Pilot with length of stay in the National Surgical Quality Improvement Program. JAMA Surgery 2018; 153(4):358-365
Lee L, Feldman LS. Enhancing surgical value and culture through enhanced recovery programs (invited review). JAMA Surg, 2017 Mar 1;152(3):299-300
Fiore JF Jr, Castelino T, Pecorelli N, Niculiseanu P, Balvardi S, Hershorn O, Liberman S, Charlebois P, Stein B, Carli F, Mayp N, Feldman LS. Ensuring early mobilization after colorectal surgery within an Enhanced Recovery Program: a randomized controlled trial. Ann Surg 2017 Aug;266(2):223-231
Madani A, Vassilou MC, Watanabe Y, Al-Halabi B, Al-Rowais MS, Grunwalkd T, Deckelbaum DLE, Fried GM, Feldman LS. What are the Principles that Guide Behaviors in the Operating Room? Creating a Framework to Define and Measure Performance. Ann Surg 2017 Feb;265(2):255-267
Lee L, Mata J, Ghitulescu GA, Boutros M, Charlebois P, Stein B, Liberman AS, Fried GM, Morin N, Carli F, Latimer E and Feldman LS. Cost-effectiveness of Enhanced Recovery Versus Conventional Perioperative Management for Colorectal Surgery. Ann Surg 2015; 262(6): 1026-33