Journal of pediatric surgery最新文献

{"title":"How Pediatric Readiness can Impact Pediatric Trauma From Every Day to Mass Events.","authors":"Deanna Dahl-Grove, Sarita Chung, Ronald Ruffing, Mary E Fallat, Michael Dingeldein, Jennifer H Aldrink, Mauricio Antonio Escobar","doi":"10.1016/j.jpedsurg.2024.162135","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2024.162135","url":null,"abstract":"<p><p>Disaster events such as weather events and mass casualty events are increasing in frequency and severity. Caring for children during a surge requires a regional approach given limited pediatric inpatient capacity and expertise. During the 2024 American Academy of Pediatrics National Convention and Exhibition, the Section on Surgery and Council on Children and Disasters (COCD) partnered to present a joint symposium emphasizing importance of pediatric readiness and disaster preparedness and role of pediatric trauma surgeons in disaster preparedness and response in all communities.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162135"},"PeriodicalIF":2.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slow Down Fluids to Speed Up the Intestine - Exploring Postoperative Ileus in Pediatric Gastrointestinal Surgery.","authors":"Alison Lehane, Mallory Perez, Charesa Smith, Yao Tian, Jane L Holl, Mehul V Raval","doi":"10.1016/j.jpedsurg.2024.162153","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2024.162153","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative ileus is a known complication of gastrointestinal (GI) surgery. In adult populations, ileus is associated with higher amounts of intraoperative intravenous (IV) fluids. This study examines the relationship between intraoperative IV fluids and postoperative ileus in pediatric patients undergoing GI surgery.</p><p><strong>Methods: </strong>The cohort, part of an 18-center prospective trial of the implementation of an enhanced recovery protocol, consists of patients (ages 10-18 years) undergoing non-emergent GI surgery. Statistical analysis compared patients with and without postoperative ileus within 30 days of surgery, stratified by receipt of intraoperative IV fluids.</p><p><strong>Results: </strong>Of 553 patients, 39 (7 %) had postoperative ileus. Patients with ileus received a higher mean amount (1453 ± 1219.7 mL vs. 1180 ± 838.7 mL, p = 0.02) of intraoperative IV crystalloid fluid and at a higher rate (9.2 mL/kg/h vs. 7.4 mL/kg/h, p = 0.03) compared to those who did not. Only 4 % of patients receiving less than 5 mL/kg/h had ileus, 6.3 % if receiving 6 mL/kg/h to 10 mL/kg/h, and 13.6 % if receiving >10 mL/kg/h. Patients with ileus had a longer length of stay compared to those who did not (11.3 ± 10.7 days, vs. 4.9 ± 6.2 days, p < 0.001). There were no statistically significant differences in reason for surgery, type of surgery, American Society of Anesthesiologists (ASA) score, preoperative opioid use, operative technique, or type of anastomosis.</p><p><strong>Conclusion: </strong>Postoperative ileus in pediatric patients undergoing GI surgery is associated with higher amounts and rates of intraoperative IV fluids. Limiting intraoperative fluids is a key target for enhanced recovery protocols in children.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162153"},"PeriodicalIF":2.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Language, Interpreter Use, and Pediatric Surgical Outcomes","authors":"Nicole Chicoine ,&nbsp;Sarah Greenberg ,&nbsp;Dwight Barry ,&nbsp;Andre Dick ,&nbsp;Hannah Cockrell","doi":"10.1016/j.jpedsurg.2024.162104","DOIUrl":"10.1016/j.jpedsurg.2024.162104","url":null,"abstract":"<div><h3>Background</h3><div>Inequities exist in pediatric surgical outcomes. Differential outcomes have been identified across racial groups, geography, and socioeconomic standing. However, the association between preferred language, interpreter use, and surgical outcomes is not well-studied in pediatric surgical literature.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of surgical patients ages 0–21 years at a quaternary pediatric hospital between 1/1/2016 - 12/31/2020. The 95 languages spoken by our cohort were grouped into English, Spanish, Asian languages, Other Indo-European languages, and Other languages. Study outcomes were 30-day post-operative mortality and serious adverse events (SAE). Logistic regression assessed the relationship between language, interpreter use, and post-operative outcomes. Deviation contrasts avoided centering non-Hispanic white English speakers. All-pairs comparisons (Turkey contrasts) determined differences between language groups.</div></div><div><h3>Results</h3><div>Among 56,655 patients, 89 % had a documented language of English, 6.7 % Spanish, 1.4 % Other, 1.3 % an Asian language, and 1.3 % an Other Indo-European language. On multivariable regression, English speakers had 54 % decreased odds of mortality (OR 0.46, 95 % CI: 0.31, 0.69), while Other language speakers had 240 % increased odds of mortality (OR 2.4, 95 % CI: 1.31, 4.41). Pairwise comparisons showed that English language speakers had reduced odds of mortality versus Other language speakers (OR 0.18, 95 % CI: 0.07, 0.45). Interpreter use was associated with a significant reduction in the odds of SAE but did not reduce mortality risk.</div></div><div><h3>Discussion</h3><div>Pediatric surgical patients with a linguistic minority preference experienced statistically significant increased odds of post-operative mortality. Additional inquiry to assess and address disparate pediatric surgical care outcomes associated with language is warranted.</div></div><div><h3>Level of Evidence</h3><div>Level III.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 3","pages":"Article 162104"},"PeriodicalIF":2.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Robotic-assisted Laparoscopic Pyeloplasty: Defining Mastery Over a 15 Year Experience","authors":"Monica H. Xing ,&nbsp;Sean Hou ,&nbsp;Alyssa Lombardo ,&nbsp;Senthooran Kalidoss ,&nbsp;Rachel Nordgren ,&nbsp;Kristina Gam ,&nbsp;Parviz Hajiyev ,&nbsp;Mohan S. Gundeti","doi":"10.1016/j.jpedsurg.2024.162121","DOIUrl":"10.1016/j.jpedsurg.2024.162121","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assisted laparoscopic pyeloplasty (RALP) has been widely utilized within pediatric urology as RALP provides additional advantages to laparoscopic pyeloplasty including a more manageable learning curve. We aim to describe the maturation and mastery of pediatric RALP through our proposed trifecta of operative time, complication rates, and surgical success rates.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 148 patients who underwent RALP between 2007 and 2022. Primary outcomes included operative time, Clavien-Dindo Grade (CDG) III complications, and surgical success rate. Patients were retrospectively divided into three cohorts (learning phase, competency phase, and mastery phase) based upon a cumulative sum (CUSUM) analysis of operative time.</div></div><div><h3>Results</h3><div>Three learning phases were differentiated at case 13 and case 41 per CUSUM analysis. Operative time significantly decreased from a mean of 261.33 ± 42.52 min in the learning phase to 140.61 ± 25.87 min in the mastery phase (<em>p</em> &lt; 0.001). CDG III complications were significantly different between phases as well, decreasing from 27.3 % to 5.75 % (<em>p</em> = 0.045). Success rates were significantly different and increased from 83 % in the learning phase to 98 % in the mastery phase (<em>p</em> = 0.015).</div></div><div><h3>Conclusion</h3><div>Successful RALP implementation, and the achievement of surgical mastery, is multifaceted and multi-phasic. Our data suggests that learning is established within the first 12 cases and mastery and maximal outcomes are achieved after 41 cases. More specifically, operative time, complication rates, and success rates become increasingly optimized at each phase of learning. Our work can be used to establish clinical goals, design training curriculums, and inform patient counseling.</div></div><div><h3>Level of Evidence</h3><div>Level III.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 3","pages":"Article 162121"},"PeriodicalIF":2.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anorectal Botulinum Toxin Injection in Functional Constipation - The Jury is Still Out.","authors":"Rishi Bolia","doi":"10.1016/j.jpedsurg.2025.162160","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2025.162160","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162160"},"PeriodicalIF":2.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheobronchopexy to Avoid Tracheostomy in Esophageal Atresia Patients With Severe Life-Threatening Tracheobronchomalacia","authors":"Hester F. Shieh ,&nbsp;Russell W. Jennings ,&nbsp;Thomas E. Hamilton ,&nbsp;Shawn Izadi ,&nbsp;Benjamin Zendejas ,&nbsp;C. Jason Smithers","doi":"10.1016/j.jpedsurg.2024.162152","DOIUrl":"10.1016/j.jpedsurg.2024.162152","url":null,"abstract":"<div><h3>Background</h3><div>Esophageal atresia (EA) is associated with tracheobronchomalacia (TBM), which in its most severe form, causes blue spells, brief resolved unexplained events (BRUEs) that can require cardiopulmonary resuscitation (CPR), and positive pressure ventilation (PPV) or ventilator dependence, often requiring tracheostomy. We study the role of tracheobronchopexy, as an alternative to tracheostomy, in EA patients with severe life-threatening TBM.</div></div><div><h3>Methods</h3><div>We reviewed EA patients who underwent tracheobronchopexy for blue spells, BRUEs, and failure to wean PPV or extubate from February 2013 to September 2021 at two institutions. Patient characteristics, surgical techniques, and respiratory outcomes were reviewed.</div></div><div><h3>Results</h3><div>80 EA patients (most Gross type C 92.5 %) underwent 91 tracheobronchopexies at median age 6 (IQR 3–14) months for blue spells/BRUEs (53 %), PPV (21 %), and ventilator dependence (26 %). On preoperative dynamic bronchoscopy, most (90 %) demonstrated complete airway collapse. Surgical approach for tracheobronchopexy was posterior (73 %), anterior (23 %), and simultaneous posterior and anterior (4 %). Tracheobronchopexy included thoracic trachea alone (58 %), trachea and bronchi (41 %), and bronchi alone (1 %). At latest follow up of median 39 (IQR 14–64) months, there were no recurrent blue spells/BRUEs (p &lt; 0.001) and significantly reduced PPV and ventilator dependence (p &lt; 0.001). Nearly all patients (n = 75, 94 %) avoided tracheostomy. Mortality was 5 %, one 30-day operative mortality and three long-term mortalities related to underlying comorbidities.</div></div><div><h3>Conclusions</h3><div>In EA patients with severe life-threatening TBM, tracheobronchopexy significantly reduces blue spells/BRUEs, PPV, and ventilator dependence, and avoids tracheostomy. This surgical strategy should be considered the treatment of choice for EA patients with severe life-threatening TBM symptoms.</div></div><div><h3>Level of Evidence</h3><div>Level IV Treatment Study.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 4","pages":"Article 162152"},"PeriodicalIF":2.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term Postoperative Complications of Lymphatic Malformation Surgical Excision: A 20-Year Institutional Review","authors":"Olivia A. Keane ,&nbsp;MaKayla L. O'Guinn ,&nbsp;Sarah Adams ,&nbsp;Erin Delfosse ,&nbsp;Sara Kreimer ,&nbsp;Jessica Lee ,&nbsp;Joseph Miller ,&nbsp;Mary Timbang ,&nbsp;Gabriel Gomez ,&nbsp;Dean Anselmo","doi":"10.1016/j.jpedsurg.2024.162146","DOIUrl":"10.1016/j.jpedsurg.2024.162146","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate outcomes and postoperative complications following surgical resection of lymphatic malformations (LMs) at a single multidisciplinary vascular anomalies center.</div></div><div><h3>Methods</h3><div>A single-center retrospective review of all patients ≤21 years old who underwent surgical resection of a lymphatic malformation at a quaternary referral center with a multidisciplinary vascular anomalies team from 2004 to 2024. Data pertaining to postoperative outcomes and treatments was abstracted.</div></div><div><h3>Results</h3><div>A total of 109 surgical procedures were included and examined. The most common 30-day postoperative complications included: seroma (18.3 %), superficial surgical site infection (18.3 %), and wound dehiscence (12.8 %), with lower rates of nerve palsy/injury (5.5 %), lymphedema (2.8 %), hematomas (3.7 %), and abscesses (4.6 %). An interventional radiology procedure within 30-days postoperatively was required for management of seroma in 8 patients (7.3 %), while 7 (6.4 %) patients required reoperation. Among patients who underwent attempted complete resection, recurrence of the LM was documented in 32.0 % (16/50). Subjective quality of life improvement was noted in 69.7 %. There was no difference in incidence of postoperative complications reported in patients who underwent preoperative sclerotherapy vs those that did not (p = 0.980).</div></div><div><h3>Conclusion</h3><div>Seroma and surgical site infection were the most reported short-term postoperative complications followed by wound dehiscence with low rates of other complications in surgical resection of LMs. Few patients required postoperative procedural intervention. Despite a relatively high rate of short-term complications, patients reported high satisfaction and symptom improvement following LM resection, which underscores the important role for surgical management of LMs in select patients.</div></div><div><h3>Level of evidence</h3><div>III.</div></div><div><h3>Type of study</h3><div>Cohort study.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 3","pages":"Article 162146"},"PeriodicalIF":2.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Canadian Experience With Magnetic Esophageal Anastomosis: A Report From the Canadian Consortium for Research in Pediatric Surgery Study (CanCORPS).","authors":"Amanda Hall, Sherif Emil, Melanie Elhafid, Elena Guadagno, Cesar Kattini, Richard Keijzer, Sarah Klapman, Jean-Martin Laberge, Michael Livingston, Pramod Puligandla, Ahmed Nasr, Phillip Snarr, Fouad Youssef, Augusto Zani","doi":"10.1016/j.jpedsurg.2024.162150","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2024.162150","url":null,"abstract":"<p><strong>Objective: </strong>Magnetic anastomosis is an innovative technique for establishing esophageal continuity in infants born with esophageal atresia. Few case series featuring this technology have been published, with even fewer reports on complications. We present the entire Canadian experience with this approach.</p><p><strong>Methods: </strong>A nationwide retrospective review of all esophageal atresia patients treated with magnetic anastomoses in Canada was conducted through the Canadian Consortium for Research in Pediatric Surgery (CanCORPS).</p><p><strong>Results: </strong>Magnetic anastomoses were attempted in nine patients including four Type A, two Type B, and three Type C. The median pre-operative esophageal gap was 2.9 cm (range 0.0-5.5 cm). In four patients, magnetic anastomosis was used as a salvage technique, after failed attempted primary repair. Seven patients (78 %) achieved esophageal patency after magnet insertion. Strictures developed in all successful cases and required a median of 10 dilatations (range 3-16). In one patient with a failed anastomosis, the proximal magnet perforated the proximal esophageal pouch, while in the second case, the magnets failed to couple together. One patient had an anastomosis form but required operative intervention shortly afterwards to both revise the anastomosis and address a missed proximal fistula.</p><p><strong>Conclusion: </strong>In the Canadian experience, magnetic anastomosis was successful in establishing esophageal continuity in most patients. However, all patients developed strictures requiring multiple dilatations, and there was a substantial risk of complications requiring additional operative procedures. Further refinement of this technique may establish magnetic anastomosis as another tool for the pediatric surgeon treating long-gap and other challenging cases of esophageal atresia.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162150"},"PeriodicalIF":2.4,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor in Response to: Reproductive Function and Fertility Preservation in Female Children, Girls, and Adolescents After Appendicular Pelvic Peritonitis: What About Abscesses?","authors":"Giovanni Rollo,&nbsp;Giorgia Romano,&nbsp;Ottavio Domenico Adorisio,&nbsp;Lorna Spagnol,&nbsp;Massimiliano Silveri","doi":"10.1016/j.jpedsurg.2024.161698","DOIUrl":"10.1016/j.jpedsurg.2024.161698","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 1","pages":"Article 161698"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Survival Disparities in Pediatric Oncology Over Time: An Analysis of the SEER Registry","authors":"Nicole J. Kus ,&nbsp;Shalini Sahoo ,&nbsp;Theodore W. Laetsch ,&nbsp;Gregory M. Tiao ,&nbsp;Minerva Mayorga-Carlin ,&nbsp;Yelena Yesha ,&nbsp;John D. Sorkin ,&nbsp;Brajesh K. Lal ,&nbsp;Brian R. Englum","doi":"10.1016/j.jpedsurg.2024.161953","DOIUrl":"10.1016/j.jpedsurg.2024.161953","url":null,"abstract":"<div><h3>Background/Purpose</h3><div>Studies have demonstrated existing racial and ethnic disparities in multiple aspects of pediatric oncology. The purpose of this study was to examine how racial and ethnic disparities in mortality among pediatric oncology patients have changed over time. We examined mortality by race and ethnicity over time within the Surveillance, Epidemiology, and End Results (SEER) registry.</div></div><div><h3>Methods</h3><div>Patients &lt;20 years-old from 1975 to 2016 (n = 49,861) were selected for the analysis. Demographic characteristics, cancer diagnosis, and mortality data were extracted. Patients were divided by race and ethnicity: 1) non-Latino White, 2) Black, 3) Latino, and 4) Other Race. The interaction between race/ethnicity and decade was evaluated to better understand how disparities in mortality have changed over time.</div></div><div><h3>Results</h3><div>Unadjusted mortality among all cancers improved significantly, with 5-year mortality decreasing from the 1970s to the 2010s (log-rank: p &lt; 0.001) for all race/ethnicity groups. However, improvements in mortality were not equal, with 5-year overall survival (OS) improving from 62.7 % in the 1970s to 87.5 % (Δ = 24.8 %) in the 2010s for White patients but only improving from 59.9 % to 80.8 % (Δ = 20.9 %) for Black patients (p &lt; 0.01). The interaction between Race/Ethnicity and decade demonstrated that the Hazard Ratio (HR) for mortality worsened for Black [HR (95 % Confidence Interval): 1.10 (1.05–1.15) and Latino [1.11 (1.07–1.17)] patients compared to White, non-Latino patients.</div></div><div><h3>Conclusion</h3><div>There has been a dramatic improvement in survival across pediatric oncology patients since 1975. However, the improvement has not been shared equally across racial/ethnic categories, with overall survival worsening over time for racial/ethnic minorities compared to White patients.</div></div><div><h3>Level of Evidence</h3><div>III.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 1","pages":"Article 161953"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}