Waël C. Hanna

Waël C. Hanna
McMaster University | McMaster · Division of Thoracic Surgery

MDCM, MBA, FRCSC

About

158
Publications
7,947
Reads
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1,172
Citations
Introduction
My research practice is geared towards advancing the science of Lung Cancer Surveillance, Robotic Lung Cancer Surgery, and Quality Improvement in Thoracic Surgery. My clinical practice is centred around Thoracic Oncology. I work with patients of Lung Cancer, Esophageal Cancer, and Mediastinal Tumors. My team and I perform highly complex Robotic Thoracic Surgery, Minimally Invasive Video-Assisted Thoracic Surgery (VATS), Endobronchial Ultrasound (EBUS) and Endoscopic UItrasound (EUS)
Additional affiliations
July 2018 - present
McMaster University
Position
  • Professor (Associate)
April 2018 - present
McMaster University
Position
  • Professor (Associate)
July 2016 - present
McMaster University
Position
  • Associate Member
Education
July 2015 - July 2016
July 2001 - July 2005
McGill University
Field of study

Publications

Publications (158)
Article
PURPOSE Despite advancements in the early detection of esophageal cancer, optimal radiotherapy methods for treatment of early disease have not yet been determined. Moreover, the benefit of intraluminal brachytherapy on local control or survival remains controversial. We performed a systematic review to establish the role of brachytherapy as boost t...
Article
Background: Robotic surgery was integrated into some healthcare systems despite there being few well designed, real-world studies on safety or benefit. This study compared the safety of robotic with laparoscopic, thoracoscopic, and open approaches in common robotic procedures. Methods: This was a population-based, retrospective study of all adul...
Article
Full-text available
Background: For the local management of pulmonary malignancies, surgical resection and stereotactic body radiation therapy (SBRT) are mutually exclusive treatments. This study aims to assess the effectiveness of SBRT on reducing tumor viability at a histologic level in the context of pulmonary metastases. Methods: This protocol describes an open...
Article
Full-text available
While pulmonary metastases are often managed through metastasectomies, stereotactic body radiation therapy (SBRT) is a relatively novel treatment that has shown promise for this disease. This review aimed to summarize the current findings of SBRT in the treatment of pulmonary metastases. MEDLINE, EMBASE, and CENTRAL were searched for articles that...
Article
Full-text available
Background: Prolonged air leaks are increasingly treated in the outpatient setting, with patients discharged with chest tubes in place. We evaluated the incidence and risk factors associated with readmission, empyema development and further interventions in this patient population. Methods: We undertook a retrospective cohort analysis of all pat...
Conference Paper
Full-text available
25 Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non-small cell lung cancer? A single-centre propensity matching analysis. A. Alghamedi (McMaster University, Hamilton, Ont.), A. Simone (University of Ottawa, Ottawa, Ont.), H. Begum (McMaster University, Hamilton, Ont.), W. Hanna (McMaster U...
Conference Paper
Full-text available
Background: Hospital readmission after lung cancer surgery is associated with worsened overall survival. This retrospective cohort study examined whether readmission to the index hospital was associated with improved outcomes in comparison to non-index hospital readmission. Methods: Patients undergoing lung cancer resection between 2012 and 2019 we...
Conference Paper
Full-text available
Background: Chest tube management after lung resection is variable. The Enhanced Recovery after Surgery (ERAS) Society and the European Society of Thoracic Surgeons recently set out recommendations regarding postoperative chest tube management. The degree to which these guidelines are adopted is unknown; a national survey was conducted to better un...
Article
Background: Retrospective data demonstrates that robotic-assisted thoracoscopic surgery provides many benefits, such as decreased postoperative pain, lower mortality, shorter length of stay, shorter chest tube duration, and reductions in the incidence of common postoperative pulmonary complications, when compared to video-assisted thoracoscopic su...
Article
Full-text available
The effect of post-operative adverse events (AEs) on patient outcomes such as length of stay (LOS) and readmissions to hospital is not completely understood. This study examined the severity of AEs from a high-volume thoracic surgery center and its effect on the patient postoperative LOS and readmissions to hospital. This study includes patients wh...
Article
Objectives: The goal of this study was to develop a risk-adjusting model to stratify the risk of an unplanned admission to the intensive care unit (following lung resection). Methods: We performed a retrospective analysis of 3123 patients undergoing anatomical lung resections (2014-2019) in 2 centres. A risk score was developed by testing severa...
Article
Background Routine feeding jejunostomy in esophagectomy is being revaluated due to its associated postoperative complications. We performed a systematic review and meta-analysis to evaluate the impact of routine feeding jejunostomy tube insertion on mortality and post-esophagectomy outcomes. Methods Electronic databases (MEDLINE, EMBASE, and CENTRA...
Article
Background The Canada Lymph Node Score (CLNS) uses four sonographic criteria to predict the risk of malignancy in lymph nodes during endobronchial ultrasound (EBUS). CLNS may play a role in identifying targets for biopsy or re-biopsy during invasive mediastinal staging for lung cancer. However, CLNS has not yet been prospectively validated in routi...
Conference Paper
Full-text available
Background: Triple normal lymph nodes (LNs), appearing benign on computed tomography, positron emission tomography and endobronchial ultrasonography (EBUS), have a less than 6% probability of malignancy. We hypothesized that targeted sampling (TS), which omits biopsy of triple normal LNs during EBUS, is not an inferior staging strategy to systemati...
Poster
Full-text available
Background: Endobronchial ultrasound (EBUS) features like nodal size, margins, central hilar structure and necrosis have high accuracy for predicting lymph node (LN) malignancy. However, their clinical application remains limited because of high operator dependency. We hypothesized that an artificial intelligence convolutional neural network (CNN)...
Poster
Full-text available
Background: Robotic-assisted thoracic surgery (RTS) has been demonstrated to be safe and effective but is associated with high capital and operating costs that are not reimbursed by many third-party payers, including the Canadian government, limiting patient access to this platform. We hypothesized that Canadian patients who had received RTS on res...
Conference Paper
Full-text available
Background: Preconditioning before surgery can lower complication rates after surgery and hence length of stay (LOS) in hospital. Therefore, we designed and compared Move For Surgery (MFS), a home-based, preoperative, preconditioning program intervention for thoracic surgery patients that involves aerobic exercise using wearable technology and deep...
Article
OBJECTIVE) Triple Normal lymph nodes, appearing benign on CT, PET, and endobronchial ultrasound, have <6% probability of malignancy. We hypothesized that Targeted Sampling (TS), which omits biopsy of Triple Normal lymph nodes during endobronchial ultrasound, is not an inferior staging strategy to Systematic Sampling (SS) of all lymph nodes. METHO...
Article
PurposeRadiomics, a method used to extract large amount of data, may be useful for discriminating malignant characteristics for lung cancer staging. We aimed to critically appraise the current use of radiomics in medical imaging for determining nodal involvement in lung cancer.Methods The literature was searched using Cochrane Central Register of C...
Article
OBJECTIVES The large volume of scientific publications and the increasing emphasis on high-quality evidence for clinical decision-making present daily challenges to all clinicians, including thoracic surgeons. The objective of this study was to evaluate the contemporary trend in the level of evidence (LOE) for thoracic surgery clinical research. M...
Article
Background: Minimally-invasive lung resections can be particularly challenging in obese patients. We hypothesized robotic surgery (RTS) is associated with less conversion to thoracotomy than thoracoscopic surgery (VATS) in obese populations. Methods: The STS GTSD, Epithor French National Database, and McMaster University Database were queried fo...
Poster
Robotic-assisted thoracic surgery has been demonstrated to be safe and effective but is associated with high capital and operating costs which are not reimbursed by the Canadian government, limiting patient access to this platform. We hypothesized that Canadian patients who had experienced robotic surgery on research or philanthropic funds would ha...
Conference Paper
Preconditioning before surgery can lower complication rates post-surgery, and hence shorten the length of stay (LOS) in hospital. However, there are significant barriers to the adoption of preconditioning in the lung cancer population, which is characteristically older, suffers multiple comorbidities, and is averse to exercise. In an effort to over...
Article
Objective: To analyze esophageal cancer patients who previously underwent neoadjuvant therapy followed by a curative resection to determine whether additional adjuvant therapy is associated with improved survival outcomes. Summary Background Data: Neoadjuvant therapy followed by surgery is the standard of care for locally advanced esophageal can...
Article
Background: Endobronchial Ultrasound (EBUS) features have high accuracy for predicting lymph node (LN) malignancy. However, their clinical application remains limited due to high operator dependency. We hypothesized that an Artificial Intelligence algorithm (NeuralSeg) is capable of accurately identifying and predicting LN malignancy based on EBUS...
Article
Background: Currently, consensus on the effectiveness of incentive spirometry (IS) following cardiac, thoracic, and upper abdominal surgery has been based on randomized controlled trials (RCTs) and systematic reviews of lower methodological quality. To improve the quality of the research and to account for the effects of IS following thoracic surge...
Conference Paper
e16083 Background: While neoadjuvant therapy followed by esophagectomy is the standard of care for locally advanced esophageal cancer, the role of adjuvant therapy is uncertain. As such, this review aims to analyze esophageal cancer patients who previously underwent neoadjuvant therapy followed by a curative resection (negative margins) to determin...
Article
Venous Thromboembolism (VTE), which comprises pulmonary embolus (PE) and deep vein thrombosis (DVT), is a significant cause of postoperative morbidity and mortality. This pilot randomized control trial (RCT) evaluated the feasibility of a full-scale RCT investigating extended thromboprophylaxis in patients undergoing oncological lung resections. Pa...
Article
Full-text available
Background The optimal analgesia method in video-assisted thoracoscopic surgery (VATS) remains controversial. Intercostal nerve blockade (ICNB) is limited by its duration of action. The erector spinae plane (ESP) block has the potential to provide satisfactory analgesia for VATS; however, the effectiveness of continuous ESP versus surgeon-performed...
Article
Background Staging guidelines for lung cancer recommend endobronchial ultrasound (EBUS) and systematic biopsy of at least 3 mediastinal lymph node (LN) stations for accurate staging. A 4-point ultrasonographic score (Canada Lymph Node Score- CLNS) was developed to determine the probability of malignancy in each LN. A LN with a CLNS<2 is considered...
Preprint
Full-text available
Background: The optimal analgesia method in video-assisted thoracoscopic surgery (VATS) remains controversial. Intercostal nerve blockade (ICNB) is limited by its duration of action. The erector spinae plane (ESP) block has the potential to provide satisfactory analgesia for VATS; however, the effectiveness of continuous ESP versus surgeon-performe...
Preprint
Full-text available
Background: The optimal analgesia method in video-assisted thoracoscopic surgery (VATS) remains controversial. Intercostal nerve blockade (ICNB) is limited by its duration of action. The erector spinae plane (ESP) block has the potential to provide satisfactory analgesia for VATS; however, the effectiveness of continuous ESP versus surgeon-performe...
Article
Full-text available
Article
Objective Thoracic surgery is associated with significant rates of postoperative morbidity and post-discharge return to the hospital or emergency departments (ED). This study aims to assess the impact of a novel integrated patient-centered, hospital-based multidisciplinary community program (Integrated Comprehensive Care-ICC) on post-discharge outc...
Article
Introduction: Recent health technology assessments (HTAs) of robot-assisted radical prostatectomy (RARP) in Ontario and Alberta, Canada, resulted in opposite recommendations, calling into question whether benefits of RARP offset the upfront investment. Therefore, the study objectives were to conduct a cost-utility analysis from a Canadian public p...
Article
Background: Esophageal cancer is associated with poor prognosis. Diagnosis is often delayed, resulting in presentation with advanced disease. We developed a clinical score to predict the risk of a malignant diagnosis in symptomatic patients prior to any diagnostic tests. Methods: We analyzed data from patients referred to a regional esophageal d...
Article
Background: Ultrasonographic features can be used to predict mediastinal lymph node malignancy during endobronchial ultrasonography. Despite the validity of using these features for this purpose, the features are not being widely used in clinical practice. This may be attributable to the absence of educational programs that teach clinicians how to...
Conference Paper
Full-text available
Objectives: Thoracic surgery is associated with significant post-discharge readmissions or Emergency Department (ED) visits. Post-discharge interventions to improve outcomes and reduce readmission and ED visits have not been systematically evaluated to date. The Integrated Comprehensive Care (ICC) is a novel patient-centered, nurse navigator led, h...
Article
Background: Academic surgeons are encouraged to promote their work on social media. We hypothesized that thoracic surgeons who are active on Twitter have a higher research citation index (h-index) than their counterparts who are not. Methods: Thoracic surgeons on CTSNet.org in Canada and the United States were queried for profiles with an h-inde...
Article
Objective(s): During endobronchial ultrasound (EBUS) staging, ultrasonographic features can be used to predict mediastinal lymph node (LN) malignancy. We sought to develop the Canada Lymph Node Score a tool capable of predicting LN metastasis at the time of EBUS. Methods: Patients undergoing EBUS staging for lung and esophageal cancer were prosp...
Conference Paper
Background) Following upper abdominal surgery (including cardiac and thoracic surgery), patients are at risk of experiencing postoperative pulmonary complications (PPC). Incentive spirometry is a rehabilitation therapy that is used to improve pulmonary expansion and maximal inhalation. The objective of this review is to determine if the use of post...
Article
Objectives: The study objectives were to evaluate the immediate, short-, and medium-term efficacy and safety of pulmonary artery branch sealing using an ultrasonic vessel-sealing device in minimally invasive anatomic lung resection. Methods: This study consists of a prospective, phase 2, multicenter, international clinical trial (clinicaltrials....
Article
Full-text available
Background: The Venous Thromboembolism Prophylaxis (VTE-PRO) randomized trial is a pilot study evaluating the impact of extended-duration prophylaxis on venous thromboembolic events in patients undergoing lung cancer resection. Enrolled VTE-PRO participants self-inject either low-molecular weight heparin or a saline placebo for 30 days postoperati...
Conference Paper
Title: The VTE PRO: A Double Blind, Randomised Control Trial Comparing Extended, Post-discharge Venous Thromboembolic Events Prophylaxis with placebo in Patients Undergoing Major Oncological Lung Resections Authors: Yaron Shargall MD1,4, Yessica Lopez-Hernandez BA1, Terri Schnurr RN1, Laura Schneider MSc1, Lori-Ann Linkins MD MSc2, Mark Crowthe...
Conference Paper
Objective: Resectable esophageal cancers are commonly treated with the CROSS protocol, but the role of postoperative adjuvant treatment for this population is less clear. We assessed the impact of operative lymph nodes status on patient survival following tri-modality therapy. Methods: Patients undergoing esophagectomy for malignant tumors at 3...
Conference Paper
Objectives: Perioperative Venous Thromboembolic Events (VTE) are associated with significant morbidity and mortality. These events are considered a potential surrogate for higher tumor aggressiveness, potentially impacting long term outcomes. A recent report by our group demonstrated 12.1% perioperative VTE prevalence. We hypothesized that the subg...
Article
Background: Near-infrared fluorescence mapping with indocyanine green dye is a recent advancement in minimally invasive segmental resection. This technique has not yet been reproduced, validated, or objectively evaluated in a large prospective case series. We hypothesized that near-infrared fluorescence mapping is associated with an increased onco...
Conference Paper
Full-text available
Background (47/50): Prolonged air leak following lung resections remains a common postoperative complication. With more minimally invasive resections and earlier hospital discharges, more patients are expected to be discharged home with a chest tube. We evaluated the outcomes of those patients and potential risk factors associated with adverse outc...
Poster
Academic surgeons are encouraged to promote their work on social media to reach a larger audience. We hypothesized that thoracic surgeons who are active on Twitter have a higher research citation index (h-index) than their counterparts who are not.
Article
Objectives: The purpose of this study was to determine the frequency, characteristics, and survival of second primary lung cancer initially identified as an indeterminate lesion on the original computed tomography scan and then diagnosed during the surveillance period in a prospective study. Methods: A prospective database of 271 patients enroll...
Conference Paper
The Addition of a Mobile App Technology to a Post-Discharge Home Care Program Following Major Lung Resection Reduces the Rate of Emergency Room Visits Authors: Jenelle Taylor MD; Waël C. Hanna MDCM MBA; John Agzarian MD MPH; Kristen Hughes MD; Patrice Pinkney MD; Yessica Lopez-Hernandez BA; Michal Coret BHSc, Laura Schneider MSc; Christian Finley...
Conference Paper
Full-text available
Objective: Minimally invasive segmentectomy is a challenging operation. Near-Infrared Fluorescence (NIF) imaging with Indocyanine Green (ICG) dye is reported to facilitate this operation by delineating parenchymal intersegmental planes. However, this novel technique has not been prospectively evaluated. As the demand for segmentectomy rises, we aim...
Article
Objectives: Minimally invasive surgery is accepted for early-stage lung cancer, but its role in locally advanced disease is controversial, especially using a robotic platform. The aim of this retrospective study was to assess the safety and effectiveness of robot-assisted resection in patients with Stage IIIA non-small-cell lung cancer (NSCLC) or...
Article
Background: Incentive spirometry (IS) is thought to reduce the incidence of postoperative pulmonary complications (PPC) after lung resection. We sought to determine whether the addition of IS to routine physiotherapy following lung resection results in a lower rate of PPC, as compared to physiotherapy alone. Methods: A single-blind prospective r...