About CATS

Vision

Enabling Canadian Thoracic Surgeons to provide the highest level of care to every patient, every time

Mission

A collaborative network that promotes excellence in patient centered care, fosters innovation, and enhances quality through education, research and advocacy

Our Committees

Latest Best Practice Commitee Recommendations

Management of Pericardial Effusions – When to Intervene, and How?

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Management of Pericardial Effusions – When to Intervene, and How? Dhruvin H. Hirpara Najib Safieddine Background Pericardial effusions are often classified based on size, with small effusions (50-100mL) measuring less than 10mm in thickness, moderate effusions (100-500mL) measuring 10-20mm in thickness, and large effusions (>500mL) measuring more than 20mm in thickness on echocardiographic as

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Management of Empyema

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Management of Empyema Basil Nasir Najib Safieddine Background Empyema, or pus in the pleural space, in its various clinical manifestations and stages is a common occurrence that thoracic surgeons are frequently asked to manage. This set of recommendations aims to provide an approach to the management of empyema based on best current evidence in the

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Guidelines for Enhanced Recovery After Lung Surgery (ERAS)

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Guidelines for Enhanced Recovery After Lung Surgery (ERAS) Armen Parajian1 1 Department of Thoracic Surgery, Lakeridge Health Oshawa and The Durham Regional Cancer Center, Oshawa ON, Canada Background Enhanced Recovery After Surgery, or ERAS, can be considered an evidence-based treatment paradigm for all surgical patients. It’s fundamental tenets are the development and systematic implementation

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Preoperative Physiologic Assessment Prior to Pulmonary Resection

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Preoperative Physiologic Assessment Prior to Pulmonary Resection Simon Turner1, Serena Shum2, Tim van Haaften2 1Thoracic Surgery, University of Alberta 2Anesthesiology, University of Alberta Background Anatomic lung resection is the gold standard treatment for early stage lung cancer but may be associated with significant risks of postoperative morbidity and mortality. To reduce the incidence of a

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Indications for Surgical Lung Biopsy and Risk Stratification

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ILD: Indications for Surgical Lung Biopsy and Risk Stratification Authors: Laura Donahoe & Sean McFadden Reviewer: Anne-Sophie Laliberte & Andrew Seely Background Interstitial Lung Diseases (ILDs) are a group of heterogeneous diseases of the lung, with variable clinical features, treatment and prognosis. The diagnosis of ILD is based on clinical features, temporal behaviour of symptoms

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Follow Up and Surveillance of Esophageal Cancer Treated With Curative Intent

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Follow Up and Surveillance of Esophageal Cancer Treated With Curative Intent Authors: Anne-Sophie Laliberté, MD. FRCSC Reviewers : Brian Johnston and Andrew Seely Society recommendations Based on society recommendations and expert consensus, there is no high level of evidence to guide in the development of algorithms. The majority of recurrences (44%)1 occur in the first two

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Opioids After Elective Ambulatory Thoracic Surgery

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Guideline on the Prescription and Management of Opioids After Elective Ambulatory Thoracic Surgery Background Although the extent of contribution of post-surgical opioid prescription to the opioid crisis in Canada (and worldwide) remains a matter of debate, it is well established that opioids are significantly over prescribed. Some studies have shown that more than half of

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Malignant Pleural Effusions

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Recommendation for the Management of Malignant Pleural Effusions  Daniel Jones, Laura Donahoe, Najib Safieddine Background Malignant pleural effusions (MPE) is a common diagnosis in patients with late stage cancer. The majority of patients experience some degree of breathlessness, which has profound effects on their remaining quality of life. Indeed, life expectancy is severely reduced with

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ERATS for Esophagectomy

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Best Practice Recommendations on Enhanced Recovery after Thoracic Surgery (ERATS) for Esophagectomy N Seyednejad, B. Johnson, G. Darling, A. Seely Background Enhanced Recovery After Surgery aims to approach the care of surgical patients in a multimodal, multidisciplinary manner to in order to improve surgical outcomes and quality of care. Enhanced Recovery After Surgery (ERAS) programs

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Subsolid Lung Nodule, Invasive Lung Cancer & Metastatetomy

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Intraoperative Mediastinal Lymphnode Sampling vs Dissection for Subsolid Lung Nodule, Invasive Lung Cancer and Metastatetomy Basil Nasir, Simon Turner, Gail Darling Summary of Recommendations* *For complete discussion, rationale, definitions and evidence, please refer to full version. Full Version of Recommendations

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Position on E-cigarettes

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CATS Position on E-cigarettes Background The major reason people will use e-cigarettes, or vape as it is commonly known, is for nicotine intake. The e-cigarette devices and the available products for vaporization have been sold by companies as an alternative to combustible tobacco cigarettes and their known harmful effects. Other substances for recreational use, marijuana

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Post-operative Atrial Fibrillation after Non-cardiac Thoracic Surgery

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Recommendations from a Review and Analysis of Strategies for Prediction, Prevention and Management of Post-operative Atrial Fibrillation after Non-cardiac Thoracic Surgery. Background: Atrial fibrillation (AF) is the most commonly sustained arrhythmia after non-cardiac thoracic surgery, occurring between 12%-44% of pulmonary and esophageal resections, and is associated with a significant increase

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Brain Imaging in Lung Cancer Staging

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Recommendation Regarding Brain Imaging in Lung Cancer Staging. Background: Brain imaging is an important component of the accurate staging of newly diagnosed patients with non-small cell and small cell lung cancer. However, there is a paucity of robust evidence in the literature to give guidance as to the best imaging modality and those that should

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Surgical Wait-Times for Resectable Lung Cancer

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Surgical Wait-Times for Resectable Lung Cancer. Background: Timely care is a fundamental component of quality. Although what constitutes timely care in lung cancer remains a subject of debate, many international/national/regional bodies have set consensus targets for wait times. Given the lack of level I evidence, the committee reviewed various recommendations and adopted one best supported

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Perioperative VTE Prophylaxis

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Recommendation for Thoracic Surgery Perioperative VTE Prophylaxis. Background: It is now widely accepted that the true incidence of post-op VTE following lung and esophageal resection is largely under-reported. A large range of incidence has been reported, with variations mainly related to different detection methods, type and duration of prophylaxis, and the subclinical nature of a

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Follow-up and Surveillance – Curatively-Treated Lung Cancer

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Follow-up and Surveillance Recommendations for Patients Treated Curatively for Lung Cancer. Background: Despite advances in the care of patients with NSCLC, the overall 5-year survival for patients treated with curative intent remains poor. The rationale for surveillance following the treatment of lung cancer is the detection of recurrent disease or a new primary lung cancer,

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Invasive Mediastinal Staging for Potentially Resectable NSCLC – Choice of Invasive Modality

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Recommendations for Invasive Mediastinal Staging for Potentially Resectable NSCLC – Choice of Invasive Modality

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Position on Lung Cancer Screening

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Lung Cancer Screening. Background: The positions and recommendations herein should be regarded as the product of a non-systematic literature review. They are however in accordance (with some specific societal variations) with the positions advocated by the Canadian Task Force on Preventive Health Care, the US Preventive Services Task Force, the American College of Chest Physicians,

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