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

{"title":"Four Techniques for Closing Laparoscopic Ports in Obese Patients.","authors":"Milton Alberto Muñoz-Leija, Jesús Gabriel Rosales-Vázquez, Gabriel Rosales-Pérez, Guillermo Álvarez-Valdés","doi":"10.4293/JSLS.2025.00121","DOIUrl":"10.4293/JSLS.2025.00121","url":null,"abstract":"<p><strong>Objective: </strong>The study objective was to compare the complication rates of four different techniques for closure: (1) no closure, (2) conventional closure with Vicryl, (3) Carter-Thomason, (4) M-Close in patients with obesity.</p><p><strong>Methods: </strong>The study design is a retrospective comparison of four surgical cohorts. All results refer to 12-mm supraumbilical incisions after laparoscopic surgery in patients with obesity. All patients had at least 12 months of follow-up.</p><p><strong>Results: </strong>Second surgery for a hernia was performed in 7 (12%) of 57 no-closure patients, 4 (8%) of 53 conventional closure patients, 1 (3%) of 31 Carter-Thomason patients, and 0 of 118 M-Close patients (overall difference: <i>P</i> < .001). The 95% confidence interval for these percentage rates of second surgery for hernia was: 5.3-21.1% for no closure, 1.9-15.1% for conventional closure, 0-9.7% for Carter-Thomason, and 0-0% for M-Close. Noteworthy differences for other complications were also found.</p><p><strong>Conclusions: </strong>This study suggests that M-Close reduces the rate of second surgery for hernia. The results also reinforce guideline recommendations that all incisions 10 mm or larger should be closed. This report provides a basis for planning randomized comparative trials.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513250","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":"A Reproducible Method of Measuring the Esophageal Hiatus and Potential Use in Hiatal Hernia Repairs.","authors":"Hiley Cammock, Sarah Couch, Danial A Malik, Jeremy T Gaskins, Farid Kehdy","doi":"10.4293/JSLS.2025.00110","DOIUrl":"10.4293/JSLS.2025.00110","url":null,"abstract":"<p><strong>Objective: </strong>Esophageal hiatus closure during hiatal hernia repair is essential. Improper closure can lead to recurrence and high patient morbidity. Our aim is to introduce an easy and reproducible method of calculating the surface area (hiatal surface area [HSA]) of the esophageal hiatus. Standardization of this value will enable surgeons to have an evidence-based approach for hiatal hernia closure during laparoscopic repair.</p><p><strong>Methods and procedures: </strong>We developed a measurement of HSA of the esophageal hiatus corresponding to a right-angle triangle: Area = (1/2) base × height. The height was defined as the left crus of the diaphragm. The base was defined as perpendicular to the crus and tangential to the medial edge of the esophagus. The mean esophageal hiatus surface area was calculated from deceased patients without a hiatal hernia undergoing full autopsies and compared to patients undergoing laparoscopic repair.</p><p><strong>Results: </strong>A total of 237 (37 cadaveric) hiatuses were measured. The median HSA defect in the cadaveric group was 1.97 cm² with an interquartile range (IQR) of 1.13 to 3.0 cm² was significantly larger compared to 5.0 cm² with an IQR of 3.5 to 7.5 cm² in the operative group (<i>P</i> < .001). Multivariate linear regression demonstrated an overall significant positive correlation between esophageal hiatus surface area defect and the variables of age and weight but not with gender.</p><p><strong>Conclusion: </strong>This study demonstrated a new reproducible method of measurement for esophageal hiatus. The significant difference between the two groups suggests that our formula can be utilized to develop a standardized value for the surface area of the esophageal hiatus.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486480","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":"A Systematic Review of Gallbladder Anomalies.","authors":"Hideo Takahashi, Rhea Raj, Amanda Hughes, Olivia Katz, Ganesh Gunasekaran","doi":"10.4293/JSLS.2025.00102","DOIUrl":"10.4293/JSLS.2025.00102","url":null,"abstract":"<p><strong>Background: </strong>Gallbladder anomalies are rare congenital defects resulting from developmental disruptions. These variations in shape, position, or number are often incidental findings but can present with symptomatic gallstone disease. Undiagnosed anomalies may lead to surgical complications like bile duct injuries and incomplete cholecystectomy. Despite their clinical significance, standardized guidelines remain limited. This systematic review consolidates current knowledge on classification, diagnosis, and management.</p><p><strong>Methods: </strong>Given the rarity of gallbladder anomalies, single case reports were excluded. The database search yielded 3,789 articles, with 1,975 excluded based on language, relevance, and duplication. After screening, 164 articles underwent full-text review, and seven case series met inclusion criteria.</p><p><strong>Results: </strong>The selected studies covered embryological development, classification, diagnostic imaging, and surgical approaches. Common imaging methods included ultrasound, magnetic resonance cholangiopancreatography (MRCP), and computed tomography (CT) scans.</p><p><strong>Discussion: </strong>Gallbladder anomalies pose diagnostic and surgical challenges, increasing the risk of bile duct injury. Greater awareness and standardized guidelines are needed. This review highlights early recognition and tailored intervention to optimize outcomes, emphasizing the need for standardized protocols.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052753","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":"Ruptured Tubal Ectopic Pregnancy Managed by Salpingectomy: vNOTES versus Conventional Laparoscopy.","authors":"Mehmet Genco, Merve Genco","doi":"10.4293/JSLS.2025.00114","DOIUrl":"10.4293/JSLS.2025.00114","url":null,"abstract":"<p><strong>Background: </strong>Ruptured tubal ectopic pregnancy continues to pose a critical challenge in gynecologic emergencies. While conventional laparoscopy (CL) has long been the preferred operative method, transvaginal natural orifice transluminal endoscopic surgery (vNOTES) is increasingly recognized for its minimally invasive characteristics. However, comparative data between these techniques in acute cases remain scarce.</p><p><strong>Methods: </strong>The present retrospective analysis reviewed women treated with salpingectomy for ruptured tubal ectopic pregnancy between Sep 2023 and Jan 2025. Twenty-four patients were evaluated, of whom 12 underwent vNOTES and 12 underwent CL. Baseline clinical and demographic features were similar across both groups. Perioperative and short-term postoperative outcomes were systematically analyzed.</p><p><strong>Results: </strong>The vNOTES technique demonstrated a significantly reduced operative time (30 ± 10 minutes) compared to CL (41 ± 14 minutes, p < 0.05). Insufflation pressure averaged lower in the vNOTES group (8 mmHg) than in the CL group (13 mmHg), with a statistically significant difference (p < 0.05), whereas hematocrit variations and postoperative opioid requirements remained comparable between the two methods. Pain evaluations at 1, 6, and 24 hours postsurgery indicated lower pain levels in the vNOTES cohort versus the CL cohort (p < 0.05). Shoulder tip discomfort was reported by 17% of vNOTES patients, in contrast to 83% of CL patients (p < 0.05). Hospital stay duration was markedly shorter for vNOTES recipients (36 ± 13 hours) compared to CL patients (55 ± 14 hours, p < 0.01). Pelvic drains were needed in 8 out of 12 CL cases, but none were required in the vNOTES group (p < 0.01). Neither group experienced intraoperative complications or required conversion to laparotomy. This single-center, retrospective study has limitations due to its small sample size (n = 24), limited generalizability, and reduced statistical power to detect rare complications.</p><p><strong>Conclusions: </strong>In this cohort, vNOTES demonstrated shorter operative times, reduced insufflation pressures, and enhanced postoperative recovery compared with conventional laparoscopy. The results indicate that vNOTES could serve as a promising surgical alternative for selected patients presenting with ruptured ectopic pregnancy. Future multicenter investigations involving larger populations and extended follow-up periods-including assessments of fertility and quality of life-will be crucial to validate these findings.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486531","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":"Artificial Intelligence Across the Society of Laparoscopic and Robotic Surgeons Publication Network.","authors":"Michael S Kavic, Raymond J Lanzafame","doi":"10.4293/JSLS.2026.00007","DOIUrl":"10.4293/JSLS.2026.00007","url":null,"abstract":"","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486459","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":"Risk Factors for Complicated Tubo-Ovarian Abscess Surgery.","authors":"Alaattin Karabulut, Sercan Kantarcı, Sevim Selen Karabulut, Uğurcan Dağlı, Didem Sezen, Alper İleri, Abdurrahman Hamdi İnan, Volkan Karataşlı","doi":"10.4293/JSLS.2025.00131","DOIUrl":"10.4293/JSLS.2025.00131","url":null,"abstract":"<p><strong>Objective: </strong>To identify clinical, laboratory, radiologic, and operative factors associated with intraoperative complications during surgical management of tubo-ovarian abscess (TOA), and to describe evolving surgical trends over a 10-year period.</p><p><strong>Methods: </strong>This retrospective cohort study included 177 women who underwent operative treatment for TOA between January 2015 and June 2025 at a tertiary referral center. Demographic variables, laboratory parameters, radiologic findings, operative details, and postoperative outcomes were extracted from institutional records. Patients were grouped as uncomplicated or complicated according to the presence of bowel, bladder, or ureteral injury. Groups were compared using appropriate statistical tests.</p><p><strong>Results: </strong>Of 177 patients, 9 (5.1%) experienced intraoperative organ injury. Complicated cases were significantly older (49 vs 42 years, <i>P</i> = .006) and exhibited higher C-reactive protein (CRP) levels (299 vs 188 mg/L, <i>P</i> = .004), higher platelet counts (544,000 vs 351,000/µL, <i>P</i> = .002), elevated platelet-to-lymphocyte ratio (PLR) (240.9 vs 186.8, <i>P</i> = .010), and lower mean platelet volume (MPV) (7.80 vs 8.70 fL, <i>P</i> = .019). Abscess size and bilaterality were not associated with complications. Extensive surgery was more frequently performed in the complicated group. A pronounced shift toward minimally invasive surgery was observed, with laparoscopy becoming the predominant approach after 2023 and all cases in early 2025 performed laparoscopically. Complicated surgeries were associated with longer operative times, greater postoperative hemoglobin decline, prolonged hospitalization, and markedly higher reoperation rates.</p><p><strong>Conclusion: </strong>Older age, elevated inflammatory markers, and altered platelet indices may help identify patients at increased risk of operative difficulty. The growing use of laparoscopy supports its role as a feasible and increasingly preferred surgical approach in the management of TOA.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227204","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":"Fluorescent Cholangiogram-Optimal Dose and Timing.","authors":"Tsanko I Yotsov, Paolina Al Kamenova, Adriana An Vricheva, Martin P Karamanliev, Polina G Marinova, Meri D Shoshkova, Dobromir D Dimitrov","doi":"10.4293/JSLS.2025.00132","DOIUrl":"10.4293/JSLS.2025.00132","url":null,"abstract":"<p><strong>Background: </strong>A bile duct injury (BDI) is a serious complication of laparoscopic cholecystectomy (LC). In the United States the reported incidence is about 0.2%, with approximately 750,000 LCs performed annually. Fluorescent cholangiogram (FC) with indocyanine green (ICG) is a novel technique aimed at reducing the incidence of BDI. Still, there are differences regarding the optimal doze and timing of ICG administration prior to LC.</p><p><strong>Methods: </strong>We performed FC with 3 different doses of ICG (0.05 mg/kg, 1 and 2 mg) injected at 3 different time intervals prior to LC (1, 3, and 6 hours) for a total of 9 different visualizations. Images of the visualized of bile tree anatomy were obtained under white light and near infrared light (NIR) for all cases. A survey questionnaire was prepared and sent out to practitioners via Google Form.</p><p><strong>Results: </strong>A total of 122 people completed the survey. Most of them preferred visualization with 1-mg ICG injected 3 hours preoperatively. Only 16% of practitioners reported routine use of FC, however 87% found the method useful. When asked if they were willing to use the method routinely, specialists were significantly more likely to respond with \"No\" (χ² = 4.438, df = 1, <i>P</i> = .035, ϕ = -0.191).</p><p><strong>Conclusion: </strong>FC is a useful technique that is still not widely adopted, but has a high level of appreciation for its usefulness.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513175","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":"Implementation of a Safe Cost Reduction Strategy for Laparoscopic Sleeve Gastrectomy.","authors":"Scott Z Mu, Moamena El-Matbouly, Hector M Lopez, Alan A Saber","doi":"10.4293/JSLS.2025.00099","DOIUrl":"10.4293/JSLS.2025.00099","url":null,"abstract":"<p><strong>Background: </strong>We conducted a quality improvement initiative aimed at reducing operating room disposable supply costs during sleeve gastrectomy.</p><p><strong>Methods: </strong>We implemented a cost reduction strategy for all sleeve gastrectomy operations at a single center which involved switching from ECHELON+ stapler with routine use staple line buttressing to a single-fire stapler (Titan SGS) to standardize the amount of staple reloads and afterwards, switching to the easyEndoLite stapler with shorter staple heights and selective use of staple line reinforcements and clip appliers.</p><p><strong>Results: </strong>We included 638 cases of primary laparoscopic sleeve gastrectomy performed from January 2020 to June 2024. There were no significant differences in the total operating room supply costs after switching to a single-fire stapler, but after switching to a less costly stapler and selectively using staple line reinforcements and clip appliers, we demonstrated a cost savings of $1,283 (95% confidence interval [CI]: $1,216 to $1,351) per case (<i>P</i> < .001), without any differences in length of stay or 30-day weight loss or risk of reoperation or readmission.</p><p><strong>Conclusion: </strong>During sleeve gastrectomy, surgeons should consider adopting operating room cost-reduction strategies such as selective use of clip appliers, judicious usage of staple line reinforcement material, and choosing less costly stapler devices.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105946","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":"Comparing Laparoscopic Skills Training for Gynecologic Residents Across Two Established Curricula.","authors":"Jacqueline Early, Skylar Gill, Nicole C Brzozowski, Linus T Chuang","doi":"10.4293/JSLS.2025.00124","DOIUrl":"10.4293/JSLS.2025.00124","url":null,"abstract":"<p><strong>Background and objectives: </strong>To compare the effectiveness of the Fundamentals of Laparoscopic Surgery (FLS) and Essentials in Minimally Invasive Gynecologic Surgery (EMIGS) manual skills curricula in preparing obstetrics and gynecology residents for laparoscopic vaginal cuff closure, using both objective performance metrics and subjective assessments.</p><p><strong>Methods: </strong>A randomized, blinded, and controlled study was conducted in a single institution with an obstetrics and gynecology residency program. Nine residents without prior FLS or EMIGS certification were randomized to complete either the FLS or EMIGS manual skills curriculum over 28 days. Participants were video-recorded completing five curriculum-specific tasks, the opposing curriculum without prior practice, and a laparoscopic vaginal cuff closure using barbed suture. The primary outcome was performance on the cuff closure task, assessed using a modified Global Operative Assessment of Laparoscopic Skills (GOALS) questionnaire. Secondary outcomes included individual task scores, total manual skill scores, and post-training survey responses.</p><p><strong>Results: </strong>There were no significant differences in total manual skills scores between groups (<i>P</i> = .62). FLS-trained participants scored significantly higher on intracorporeal knot tying (<i>P</i> = .0085). However, EMIGS-trained residents achieved higher scores on the vaginal cuff closure task across all postgraduate year (PGY) levels. Subjectively, though most participants found the programs dissimilar, all participants reported skill improvement. EMIGS trainees expressed lower confidence in knot tying, but most agreed EMIGS more closely resembled real-world laparoscopic surgery.</p><p><strong>Conclusions: </strong>These findings support the use of EMIGS as a gynecologic-specific simulation tool in surgical education, although further research with larger numbers of participants are needed to confirm these observations.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486550","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":"Homemade Glove-Port Platform for Ovarian Teratoma Resection in Laparoscopic Single-Site Surgery.","authors":"Dayuan Huang, Wenchen Huang, Haiyan Chen, Qiong Yang","doi":"10.4293/JSLS.2025.00101","DOIUrl":"10.4293/JSLS.2025.00101","url":null,"abstract":"<p><strong>Background: </strong>The adoption of laparoscopic single-site surgery (LESS) is limited by the high cost of commercial platforms. We present a self-designed glove-port for LESS ovarian teratoma resection.</p><p><strong>Technique: </strong>A single-port platform was constructed from a surgical glove and rings from a disposable suction tube. A specimen retrieval bag was modified with a silk drawstring and a secondary opening to create a closed system. The teratoma was dissected within the closed bag and all contents were removed via the umbilicus.</p><p><strong>Results: </strong>The procedure was successfully performed. The self-assembled port provided stable access, and the modified bag enabled complete specimen containment and extraction without spillage or auxiliary incisions.</p><p><strong>Conclusion: </strong>This technique demonstrates a safe, feasible, and low-cost alternative for LESS. Utilizing ubiquitous materials improves the accessibility of minimally invasive, cosmetically favorable surgery in resource-constrained settings.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227126","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}