JSLS : Journal of the Society of Laparoendoscopic Surgeons最新文献

{"title":"Hysterectomy for Large Uterus by Minimally Invasive Surgery (MIS).","authors":"Pengfei Wang, Liaisan Uzianbaeva, Noemi Hughes, Alireza Mehdizadeh","doi":"10.4293/JSLS.2024.00017","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00017","url":null,"abstract":"<p><strong>Background and objective: </strong>When the uterus is or more than 18 to 20 weeks in size, laparotomy but not minimally invasive surgery (MIS) is commonly performed for hysterectomy. It is, however, acknowledged that MIS carries numerous benefits to patients compared to laparotomy. The uterine size should therefore not be an excluding factor for MIS. This study aims to demonstrate the feasibility and benefits of MIS for hysterectomy for large uterus and explain specific techniques employed.</p><p><strong>Methods: </strong>Data from 73 laparoscopic and robotic hysterectomy cases were collected. Cases were divided in two groups based on uterine weight (≥500 g vs <500 g). Estimated blood loss (EBL), operative time, length of hospital stays, and perioperative complications were compared between the groups.</p><p><strong>Results: </strong>The average specimen weight in two groups was 244 ± 102.75 g vs 903 ± 438.18 g (<i>P</i> < .01). There was no statistically significant difference in length of hospital stay between the two groups. Only 3 patients were hospitalized for more than one day. There were no instances of conversion to laparotomy, intraoperative or postoperative blood transfusion. There was a statistically significant difference in the EBL (78.19 ± 43.8 ml vs 127.88 ± 69.76 ml, <i>P</i> < .01) and operative time (180.68 ± 48.36 vs 228.85 ± 53.04 minutes, <i>P</i> < .01) between the two groups. There were two cases of bladder laceration in the group with uterine weight exceeding 500 g.</p><p><strong>Conclusion: </strong>With advanced surgical skills and the adoption of specific techniques, hysterectomy for large uterus can be performed safely and efficiently by MIS.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeons' Approach to Intraoperative Complications in Total Extraperitoneal (TEP) Hernia Repair.","authors":"Mehmet Esref Ulutas, Abdullah Hilmi Yılmaz","doi":"10.4293/JSLS.2024.00020","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00020","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to determine the frequency of laparoscopic inguinal hernia repair (LIHR) and how surgeons managed complications such as intraoperative bleeding, organ damage, and peritoneal injury that may develop during this procedure.</p><p><strong>Methods: </strong>The data for the study were collected through an electronic survey created using Google Forms and sent using WhatsApp in May 2024.</p><p><strong>Results: </strong>The study included 220 of 250 surgeons (88%) working in 25 healthcare centers located in different regions where the survey was distributed. Fourteen respondents with missing data were excluded from the study. The mean age of the remaining 206 participants was 39.6 (27-69) years. The rate of surgeons using laparoscopic techniques in inguinal hernia surgery was 89.3%. The method most preferred by the surgeons performing LIHR was total extraperitoneal (TEP) repair (60.9%), followed by transabdominal preperitoneal (TAPP) repair (39.1%). The surgeons preferred open procedures in patients with a history of lower abdominal surgery, those with scrotal hernia, and elderly patients. Additionally, in cases of intraoperative complications that developed at different stages of TEP, it was observed that participants mostly convert to the TAPP technique (43.5-46%), and in some cases, almost all participants continued the procedure with the same technique, i.e., TEP repair (94.6%).</p><p><strong>Conclusion: </strong>This study revealed that surgeons preferred open procedures in some specific patient groups, but they mostly preferred LIHR in the remaining cases. Young surgeons, in particular, seem more inclined to employ laparoscopic methods. In cases of intraoperative complications, most surgeons chose to continue with laparoscopic techniques.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrosurgical Devices Used During Laparoscopic Hysterectomy.","authors":"Toni S Horton, Paulette E Coombs, Yooree Ha, Zhen Wang, Tara J Brigham, Zenobia E Ofori-Dankwa, Olivia O Cardenas-Trowers","doi":"10.4293/JSLS.2024.00022","DOIUrl":"10.4293/JSLS.2024.00022","url":null,"abstract":"<p><strong>Background: </strong>Hysterectomy is one of the most common surgical procedures performed in the United States and most are now being performed in a minimally invasive approach. Electrosurgery and vessel sealing devices are needed in order to provide hemostasis and vascular coaptation; however, there is no guiding evidence and limited recommendations for the use of the currently available devices for laparoscopic hysterectomy. The purpose of this study is to provide a systematic review of electrosurgical devices used in benign hysterectomy and perform a meta-analysis to find the overall effect of various outcomes.</p><p><strong>Database: </strong>A systematic review was performed by searching the literature using MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Review, Science Citation Index Expanded, Emerging Sources Citation Index, Scopus, Epistemonikos, and SciELO databases from each database's inception date until May 2023.</p><p><strong>Conclusion: </strong>Advanced bipolar vessel sealing devices demonstrate reduced blood loss and operative times when compared to conventional electrosurgery, however more high-quality evidence and cost analysis is needed to strengthen the clinical significance of these findings.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inferior-Medial Approach to Laparoscopic Splenic Vessel-Preserving Distal Pancreatectomy.","authors":"Kee Tae Park, Joo Dong Kim","doi":"10.4293/JSLS.2024.00028","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00028","url":null,"abstract":"<p><strong>Background and objectives: </strong>Complete preservation of the splenic vessels is ideal during laparoscopic spleen-preserving distal pancreatectomy (LSPDP). However, this remains challenging and time-consuming because the vessels are often deeply embedded in the pancreatic parenchyma. Herein, we introduce our inferior-medial approach to laparoscopic splenic vessel-preserving distal pancreatectomy (lap-SVPDP) and evaluate its safety and feasibility.</p><p><strong>Methods: </strong>Forty-three patients underwent LSPDP performed by a single surgeon at our institution: 26 (60.5%) lap-SVPDPs with an inferior-medial approach and 17 with the laparoscopic Warshaw technique (lap-WT). We compared the outcomes of the 2 groups. No patient undergoing lap-SVPDP required conversion to laparotomy or lap-WT.</p><p><strong>Results: </strong>Most preoperative characteristics and postoperative outcomes did not differ between the 2 groups; neither the operation time nor the intraoperative blood loss differed despite the greater technical complexity of lap-SVPDP. The mean tumor size was greater in the lap-WT than the lap-SVPDP group (<i>P </i>=<i> </i>.001). The splenic vein patency rate of the lap-SVPDP group was not inferior to that of the open SVPDP group treated by the same surgeon.</p><p><strong>Conclusion: </strong>Inferior-medial approach lap-SVPDP could be a safe and feasible technique for lap-SVPDP; neither blood loss nor operation time is increased.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142516498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in Minimally Invasive Benign Hysterectomy.","authors":"Kamran Hessami, Marie-Claire Leaf, Jinxiao Liang, Adi Katz, Frank Chervenak, Abdelrahman AlAshqar, Mostafa A Borahay","doi":"10.4293/JSLS.2024.00018","DOIUrl":"10.4293/JSLS.2024.00018","url":null,"abstract":"<p><strong>Background and objectives: </strong>Racial and ethnic disparities in access to minimally invasive surgery (MIS) and the rate of surgical complications in minority groups remain profoundly underinvestigated. This meta-analysis aims to compare the rate of MIS utilization for benign hysterectomy as well as the surgical morbidity among racial and ethnic minority patients in the United States.</p><p><strong>Methods: </strong>Studies comparing utilization rate of MIS for benign hysterectomy among non-Hispanic white, Black, and Hispanic populations were considered eligible. The primary outcome was the rate of MIS according to race. The secondary outcome was surgical morbidity risk (Clavien-Dindo Classification) according to hysterectomy route and race. Random-effect model meta-analysis pooled unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Thirteen studies were eligible, with a total of 1,123,851 patients undergoing benign hysterectomy, of whom 817,209 were white, 187,488 Black, and 119,154 Hispanic. Black and Hispanic patients were less likely to undergo MIS compared to white patients (Black: OR 0.44 [95% CI 0.39-0.49] and Hispanic: OR 0.65 [95% CI 0.59-0.71]). After pooling adjusted estimates, the rate of MIS use remained significantly lower in nonwhite populations. Nonwhite patients were more likely to develop surgical complications after hysterectomy in either MIS (OR 1.32 [95% CI: 1.15-1.52]) or open hysterectomy (OR 1.56 [95% CI: 1.40-1.73]).</p><p><strong>Conclusion: </strong>Racial and ethnic disparities in MIS utilization for benign hysterectomy are strikingly apparent in the United States, with nonwhite patients often demonstrating lower access to MIS utilization and higher rates of surgical morbidity than white patients.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Stump Closure Methods in Laparoscopic Appendectomy: Hem-o-Lok Clip and Laparoscopic Titanium Clip.","authors":"Mehmet Uçar, Aziz Bulut","doi":"10.4293/JSLS.2024.00029","DOIUrl":"10.4293/JSLS.2024.00029","url":null,"abstract":"<p><strong>Background: </strong>Appendectomy for acute appendicitis is the most common acute abdominal surgery. Open and laparoscopic appendectomy surgeries are performed with different techniques. Laparoscopic appendectomy has become a widespread method due to its advantages. The aim of this study is to compare the complications, surgery time, hospitalization length, and cost-effectiveness of titanium clips and hem-o-lok clips for stump closure in laparoscopic appendectomy.</p><p><strong>Methods: </strong>This study included 187 patients who were operated on laparoscopically for acute appendicitis at our hospital between April 2019 and June 2022. The patients' follow-up for 30 days after surgery was evaluated. The data of 179 patients in whom titanium and hem-o-lok clips were inserted during an appendectomy were included in the study.</p><p><strong>Results: </strong>Between April 2019 and June 2022, 179 patients were included in the study retrospectively. When the correlation between complications and surgical methods was analyzed, 98.8% of the hem-o-lok clip group and 99% of the titanium clip group had no complications. No statistically significant difference was observed between complications and surgery type (<i>P</i> > .05). In the hem-o-lok and titanium clip groups, the operative time was 52.4 minutes and 53.1 minutes, and the hospitalization times were 1.7 days and 1.8 days, respectively.</p><p><strong>Conclusions: </strong>It is concluded that the use of titanium clips that completely close the root of the appendix is as safe, accessible, feasible, practical, and effective as the hem-o-lok clip method. It was observed to be used safely as an alternative to other appendix root closure methods.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot Assisted Cholecystectomy Using the BORNS Simphoni System.","authors":"Vivek Bindal, Shailesh Gupta, Dhananjay Pandey, Shahiq Ahmed","doi":"10.4293/JSLS.2024.00016","DOIUrl":"10.4293/JSLS.2024.00016","url":null,"abstract":"<p><strong>Background and objective: </strong>Robotic cholecystectomy has technical advantages of 3D visualization, enhanced instrument maneuverability, and increased precision. Less chance of conversion to open and biliary spillage. This study explores the utilization of the BORNS Simphoni Robotic System for robotic cholecystectomy.</p><p><strong>Methods: </strong>The paper discusses the safety and efficacy of the system during a phase 1 clinical trial, focusing on key technical steps, outcomes, and comparisons with conventional laparoscopic cholecystectomy.</p><p><strong>Results: </strong>Results from the trial indicate successful completion of surgeries with no conversions to open procedures, minimal blood loss, and low postoperative pain.</p><p><strong>Discussion: </strong>The BORNS Simphoni system offers advanced features such as an open console design, articulating and nonarticulating instruments, and integrated ultrasonic energy sources. The study suggests the feasibility and effectiveness of robotic cholecystectomy using the BORNS Simphoni system. However, a larger sample size is needed to further evaluate and confirm these findings, as well as to assess the cost-effectiveness of this platform for broader adoption.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vivo Measurements of Appendiceal Base - Implications on Pediatric Laparoscopic Appendectomy.","authors":"Sanimir Suljendic, Edin Husaric, Amir Halilbasic, Samir Delibegovic","doi":"10.4293/JSLS.2024.00033","DOIUrl":"10.4293/JSLS.2024.00033","url":null,"abstract":"<p><strong>Background and objectives: </strong>Securing the base of the appendix is the most critical part of laparoscopic appendectomy in children. Determining the average values of the appendix, will facilitate the creation of suitable instruments, and will also have an impact on research in imaging studies.</p><p><strong>Methods: </strong>One hundred and eight patients with the acute appendicitis were randomized into 2 groups: group I: children aged 2-10 years old, group II: children >10 years of age. Each group was further divided into 3 subgroups: phlegmonous, gangrenous and perforated forms of acute appendicitis. The external diameter of the appendiceal base, the middle part of the appendix, the tip and the length were determined. The measurements were made with the help of Vernier calipers, and expressed in millimeters.</p><p><strong>Results: </strong>In group I, the average size of the appendiceal base in the phlegmonous form was 5.68 ± 1.51 mm, in the gangrenous form 7.08 ± 1.82 mm, and in the perforated form 6.94 ± 2.43 mm. In group II, the average size of the appendiceal base in the phlegmonous form was 7.29 ± 2.75 mm, in the gangrenous form 7.24 ± 2.11 mm, and in the perforated form 9.31 ± 3.07 mm.</p><p><strong>Conclusion: </strong>Although most appendices can be removed by standard methods, the maximum sizes observed in this study reveal that standard endoloop or plastic and titanium clips cannot be used in the procedure and instead the more expensive stapler has to be utilized.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Enhanced Recovery after Surgery in the Perioperative Period for Elderly Patients with Lung Cancer.","authors":"Zhihai Wang, Miaomiao Lin, Geng Geng, Weiwei Wu, Yong Tao","doi":"10.4293/JSLS.2024.00037","DOIUrl":"10.4293/JSLS.2024.00037","url":null,"abstract":"<p><strong>Objective: </strong>To explore a model suitable for enhanced recovery after surgery (ERAS) for elderly patients with lung cancer in this region.</p><p><strong>Methods: </strong>A total of 200 elderly patients with lung cancer who were admitted to our department and received thoracoscopic surgery from January 1, 2020, to December 31, 2021, were enrolled as observation subjects and were randomly assigned to an ERAS group (100 cases) and a control group (100 cases). All patients were aware of and agreed to enter the study, and the protocols were approved by the hospital ethics committee (2021 Medical Ethics Review 26). The incidence of postoperative pulmonary complications, duration of postoperative chest tube, postoperative pain, and pulmonary function (including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1)) on postoperative day 7 were compared between the 2 groups.</p><p><strong>Results: </strong>The incidence of postoperative pulmonary complications was significantly lower in the ERAS group (8.00%) than in the control group (18.00%). The incidence of postoperative atelectasis in the ERAS group (2%) was significantly lower than that in the control group (10%). The duration of postoperative chest tube in the ERAS group (2.57 ± 0.72 days) was significantly shorter than that in the control group (3.92 ± 1.54 days). The postoperative pain score of the ERAS group (2.14 ± 0.86) was significantly lower than that of the control group (3.78 ± 1.15). On postoperative day 7, both FVC and FEV1 in the ERAS group were significantly better than those in the control group. SPSS 20 was used for statistical analysis, and the <i>P</i> < .05 was considered clinically significant.</p><p><strong>Conclusion: </strong>The ERAS model established in our department can reduce the incidence of postoperative complications, relieve postoperative pain, and better protect the lung function of elderly patients with lung cancer. The model is worth promoting because it enhances recovery after surgery and reduces the family burden of patients.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Surgery Deserts: Is There a Role for Robotic Assisted Surgery?","authors":"Brian Mitzman, Shaneeta Johnson, Maureen Lichtveld, Richard Culbertson, Zhi Ven Fong","doi":"10.4293/JSLS.2024.00039","DOIUrl":"10.4293/JSLS.2024.00039","url":null,"abstract":"<p><p>Despite evidence indicating patient and hospital benefits of minimally invasive surgery (MIS) over open surgery, there is still access barriers to MIS. Availability of training and associated learning curve, health literacy, and hospital characteristics (location, size) have been identified as the primary barriers to the adoption of MIS. Robotic assisted surgery could help to overcome some of these barriers and increase access to MIS through easier tele-mentoring and potential for remote access.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}