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1.  Oncologic specimen from laparoscopic assisted gastrectomy for gastric adenocarcinoma is comparable to D1-open surgery: the experience of a Canadian centre 
Canadian Journal of Surgery  2013;56(4):249-255.
Background
The Eastern experience has reported the safety of laparoscopic assisted gastrectomy (LAG) for gastric cancer. Its use in Western countries is still debated owing to concerns about its oncologic equivalence to open gastrectomy (OG). We sought to review and compare their operative outcomes and oncologic specimen quality (number of harvested lymph nodes and surgical margins) for gastric adenocarcinoma (GA).
Methods
We reviewed the charts of all patients undergoing LAG (2007–2010) and OG (2000–2010) for GA in a single institution. Several surgeons performed the OGs, whereas 1 fellowship-trained laparoscopic surgeon performed LAGs. The primary outcome was quality of the surgical specimen, assessed by the number of harvested lymph nodes (LNs) and margin status. Secondary outcomes were perioperative events. Data were analyzed as intention to treat.
Results
We retrieved 60 cases (47 OGs, 13 LAGs). The conversion rate was 23%. Mean operative time was 115 minutes longer and blood loss was 425 mL less (both p < 0.001) for LAGs. A mean of 14.4 (standard deviation [SD] 9.8) and 11.2 (SD 8.2) LNs were harvested for OGs and LAGs, respectively (p = 0.29). Negative margins were achieved for all patients. Mean length of stay was similar (LAG: 19 d v. OG: 18.9 d; p = 0.91). The groups did not differ on major postoperative complications (12.7% v. 23.1%; p = 0.39) or operative mortality (2.1% v. 7.7%; p = 0.32).
Conclusion
Laparoscopic assisted gastrectomy is a challenging but safe and feasible procedure in experienced hands. It offers the same radical resection as OG regarding negative margins and LN retrieval. Long-term follow-up is warranted.
doi:10.1503/cjs.002612
PMCID: PMC3728244  PMID: 23883495
2.  Audiovisual Segregation in Cochlear Implant Users 
PLoS ONE  2012;7(3):e33113.
It has traditionally been assumed that cochlear implant users de facto perform atypically in audiovisual tasks. However, a recent study that combined an auditory task with visual distractors suggests that only those cochlear implant users that are not proficient at recognizing speech sounds might show abnormal audiovisual interactions. The present study aims at reinforcing this notion by investigating the audiovisual segregation abilities of cochlear implant users in a visual task with auditory distractors. Speechreading was assessed in two groups of cochlear implant users (proficient and non-proficient at sound recognition), as well as in normal controls. A visual speech recognition task (i.e. speechreading) was administered either in silence or in combination with three types of auditory distractors: i) noise ii) reverse speech sound and iii) non-altered speech sound. Cochlear implant users proficient at speech recognition performed like normal controls in all conditions, whereas non-proficient users showed significantly different audiovisual segregation patterns in both speech conditions. These results confirm that normal-like audiovisual segregation is possible in highly skilled cochlear implant users and, consequently, that proficient and non-proficient CI users cannot be lumped into a single group. This important feature must be taken into account in further studies of audiovisual interactions in cochlear implant users.
doi:10.1371/journal.pone.0033113
PMCID: PMC3299746  PMID: 22427963
5.  Diaphragme duodénal congénital chez l’adulte associé à une localisation anormale de l’ampoule de Vater: présentation d’un cas et revue de la littérature 
Canadian Journal of Surgery  1997;40(3):231-235.
L’obstruction duodénale par un diaphragme est une entité rare chez l’adulte. Il en va de même pour l’implantation de la papille de Vater dans le troisième duodénum. Suite à l’observation d’un cas probablement unique montrant les deux anomalies associées, on présente une revue de la littérature. Le diagnostic est souvent fait en cours de chirurgie et nécessite une duodénotomie exploratrice. Le meilleur traitement exige l’excision partielle du diaphragme et la fermeture transverse de la duodénotomie. Une duodéno-jéjunostomie et (ou) une duodéno-duodénostomie sont des traitements acceptables. L’implantation de la papille de Vater dans le troisième duodénum ne nécessite aucun traitement.
PMCID: PMC3953003  PMID: 9221170

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