Obesity Surgery最新文献

{"title":"Left-Sided Sleeve Gastrectomy (LS-SG): A Safe and Efficient Approach to Bariatric Surgery.","authors":"Libero Luca Giambavicchio, Antonio Matarangolo, Hong Tham Santi, Arianna Corvasce, Antonio Braun","doi":"10.1007/s11695-025-08328-z","DOIUrl":"https://doi.org/10.1007/s11695-025-08328-z","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly performed bariatric procedures. Among the various surgical approaches, the left-sided sleeve gastrectomy (LS-SG) offers potential advantages in terms of easy access to the anatomical region, operative time, and low complication rates.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 728 patients who underwent LS-SG between November 2018 and November 2019. The surgical technique consists of the use of three ports positioned on the left side of the abdomen, allowing good visualization of the stomach and adequate stapler positioning. Operative time, complication rates, and length of hospital stay were recorded.</p><p><strong>Results: </strong>Among 728 patients (18.63% male, 81.37% female; mean age: 40 years), the mean operative time was 25 min (range 15-70). All patients were discharged after 2 days, except for one who required post-operative transfusion. One patient out of 728 (0.1%) developed a gastric fistula 5 days after being discharged.</p><p><strong>Conclusions: </strong>LS-SG is a safe, reproducible, and efficient technique for performing LSG. It offers the advantages of improved anatomical exposure, reduced operative time, and low complication rates.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of One Anastomosis Gastric Bypass: A Systematic Review and Meta-Analysis of 5-Year and Beyond.","authors":"Anuja Mitra, Amit Bhambri, Matyas Fehervari, Chetan Parmar","doi":"10.1007/s11695-025-08339-w","DOIUrl":"https://doi.org/10.1007/s11695-025-08339-w","url":null,"abstract":"<p><strong>Background: </strong>One-anastomosis gastric bypass (OAGB) has gained global prominence as the third most performed bariatric procedure. Despite evidence of short-term efficacy, long-term outcomes remain understudied.</p><p><strong>Methods: </strong>This PRISMA-compliant systematic review and meta-analysis evaluated long-term (≥ 5 years) outcomes of OAGB as primary and revisional procedures. Quality assessment and bias evaluation were conducted systematically.</p><p><strong>Results: </strong>Analysis included 32 studies with 19,125 patients (76% primary OAGB) from 14 countries with mean follow-up of 6.7 years. At five years, mean excess weight loss(EWL) was 75%, increasing to 77% beyond five years. Obesity associated diseases resolution was substantial: type 2 diabetes (80%), obstructive sleep apnea (89%), and hypertension (61%). Complications were minimal: bile reflux (4%), marginal ulceration (2%), and malnutrition (1%). For revisional OAGB, %EWL at five years was 71%. The conversion rate to other bariatric procedures (all RYGB) was reported in 3% of patients following OAGB.</p><p><strong>Conclusion: </strong>This analysis demonstrates OAGB's effectiveness for sustained weight loss and obesity associated diseases improvement at ≥ 5 years, supporting its role in long-term obesity management as a primary and revisional bariatric intervention.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Workload Disparities Between High- and Low-Volume Bariatric Surgeons: Implications for Surgical Quality and Training Policy-Insights from Taiwan's Nationwide Data (2016-2024).","authors":"Kuo-Feng Hsu, Hsin-Mei Pan, Yi-Jie Wang, Zhi-Jie Hong","doi":"10.1007/s11695-025-08322-5","DOIUrl":"https://doi.org/10.1007/s11695-025-08322-5","url":null,"abstract":"<p><strong>Background: </strong>With the increasing prevalence of bariatric surgery, surgeon case volume has emerged as a key quality indicator. However, imbalances in workload between high-, medium-, and low-volume surgeons may affect clinical outcomes.</p><p><strong>Methods: </strong>We conducted a nationwide analysis of Taiwan's bariatric surgery data from 2016 to 2024. Surgeons were categorized into three groups by annual case volume: high-volume (≥ 50 cases/year), medium-volume (10-49 cases/year), and low-volume (< 10 cases/year). Trends in procedure counts, hospital types, and surgical diversity were examined.</p><p><strong>Results: </strong>During the study period, annual procedures increased from 2,486 to 4,728. The number of high-volume hospitals (≥ 100 cases/year) doubled from 7 to 14, accounting for 88.5% of all cases by 2024. Although the number of bariatric surgeons increased from 107 to 153 in 2024, only 23 (15.0%) were high-volume; yet they performed 94.42% of all procedures. Medium-volume surgeons (n = 8) represented 5.2% of the workforce, with an average annual caseload of 29.38 cases, contributing 4.97% of procedures. Low-volume surgeons (n = 122, 79.7% of the workforce) averaged 0.24 cases per year and contributed less than 1% of the total volume. Most newly trained surgeons remained in the medium- or low-volume categories, constrained by referral patterns, institutional barriers, and limited operative access.</p><p><strong>Conclusions: </strong>This imbalance threatens workforce sustainability, skill retention, and equitable care. The findings highlight the need for policy and training reforms to better align bariatric surgery capacity with quality and access objectives.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Care Needs and Clinical and Nutritional Outcomes in Pregnant Women After Metabolic and Bariatric Surgery-A Tertiary Centre Experience.","authors":"Brian Tran, Yi Wei Chen, Minoli Vinoda Abeysekera, Gillian Rosic, Chong Liang, Nardeen Habashy, Paik Yee Liew, Michael Devadas, Supreet Saluja, Natassia Rodrigo, Kathryn Helen Williams","doi":"10.1007/s11695-025-08315-4","DOIUrl":"https://doi.org/10.1007/s11695-025-08315-4","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and bariatric surgery (MBS) is used to achieve significant and sustained weight loss. Considerable MBS are performed on women of reproductive age, with limited data regarding risks and management pre-conception and peripartum.</p><p><strong>Methods: </strong>Our retrospective audit assessed adult women in pregnancy with prior MBS, attending a specialised, multidisciplinary obesity service between January 2018 and July 2022. Baseline clinical and demographic characteristics, including surgical data, anthropometry, nutritional status, and pregnancy outcomes were collected for each pregnancy and evaluated.</p><p><strong>Results: </strong>Across 189 women and 210 pregnancies, pre-pregnancy obesity (BMI ≥ 30) prevalence was 55.9%, with polycystic ovarian syndrome and type 2 diabetes and depression and anxiety the most common associated medical and mental health problems, respectively. One-sixth of pregnancies were conceived within 12 months of MBS. Of those with available data (n = 174), only 43.1% (n = 75) had preconception dietitian reviews. Second trimester iron deficiency was noted in 64.1% (107/167) (parenteral supplementation required in 23.8% (50/210)) and vitamin B12 deficiency in 46.2% (61/132) (parenteral supplementation administered in 32.9% (69/210)). Maternal and neonatal complications occurred in 43.8% and 45.7% of pregnancies. Special care nursery (SCN) or neonatal intensive care unit (NICU) admissions were higher than background population rates.</p><p><strong>Conclusions: </strong>Women in pregnancy following MBS have complex medical and mental health backgrounds, limited pre-conception counselling and significant nutritional deficiencies, with higher rates of SCN/NICU admissions. Our study highlights the role of specialised pre-conception and perinatal services for these women.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term weight loss and metabolic outcomes after LSG and LRYGB in Chinese patients: a propensity score-matched retrospective analysis.","authors":"Ruixiang Hu, Kaisheng Yuan, Zilong Wu, Zhiyong Dong, Wah Yang, Cunchuan Wang, Bing Wu","doi":"10.1007/s11695-025-08185-w","DOIUrl":"https://doi.org/10.1007/s11695-025-08185-w","url":null,"abstract":"<p><strong>Aims: </strong>To compare weight loss and metabolic parameters changes between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-gastric bypass (LRYGB) in obese patients.</p><p><strong>Materials and methods: </strong>This retrospective study included 824 patients treated with LSG or LRYGB between January 2014 and August 2022 at the First Affiliated Hospital of Jinan University. A 1:1 propensity score matching method was used to compare the LSG and LRYGB groups. Differences in weight loss outcomes, changes in biochemical levels, and differences in nutritional status at 6- and 12- months postoperatively were assessed in different Chinese populations.</p><p><strong>Results: </strong>LSG and LRYGB groups each comprised 412 patients. The baseline characteristics of the two groups showed no significant differences. However, patients with type 2 diabetes mellitus (T2DM) who underwent LRYGB exhibited significantly reduced glycated hemoglobin (HbA1c) levels compared to those who had LSG after the 12-month postoperative follow-up. Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) levels are reduced in patients with nonalcoholic fatty liver disease (NAFLD). Alcohol consumption was shown to adversely affect surgical outcomes, with a notable association observed in postoperative weight regain. Females had lower body mass index (BMI) and blood glucose levels 6 months after LSG and lower BMI and blood pressure levels 12 months after LRYGB. Bariatric surgery caused severe nutritional deficiencies, notably affecting vitamin D levels, with over 60% of patients in both groups experiencing insufficiency postoperatively.</p><p><strong>Conclusions: </strong>Both LSG and LRYGB surgeries were determined to be safe and efficacious. LSG proved particularly beneficial for patients with NAFLD, while LRYGB was more efficacious for those with T2DM, hypercholesterolemia, and hypertensive women.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could ChatGPT Be a Tool Capable of Providing Qualified, Empathetic, and Assertive Answers to Patients After Bariatric Surgery? A Comparative Analysis of Its Versions.","authors":"André Vicente Bigolin, Juliano Nunes Chibiaque de Lima, João Vicente Machado Grossi, Isabela Hartmann Rost, Morghana Machado da Rosa, Franco Piccolotto Concolatto","doi":"10.1007/s11695-025-08306-5","DOIUrl":"https://doi.org/10.1007/s11695-025-08306-5","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) is revolutionizing healthcare by providing advanced tools that enhance clinical practice. Bariatric surgery, a key treatment for severe obesity, requires consistent postoperative care to ensure optimal outcomes, which can be challenging. AI, including ChatGPT, has been employed in various medical fields, but its role in postoperative bariatric surgery follow-up remains underexplored. This study evaluates and compares the effectiveness of ChatGPT 3.5 and 4 in responding to common postoperative questions.</p><p><strong>Methods: </strong>A cross-sectional pilot study, where a multidisciplinary team of bariatric surgery experts identified ten frequently asked questions related to the postoperative period. These questions were presented to ChatGPT 3.5 and 4 under a standardized prompt simulating a real patient interaction. The responses were evaluated by a group of specialists using criteria such as response quality, empathy, safety, and clinical acceptance. Statistical analyses were conducted to compare the performance of the two versions.</p><p><strong>Results: </strong>The analysis revealed that ChatGPT 4 showed a trend toward better performance compared to GPT-3.5, particularly in accuracy and safety, although several comparisons did not reach statistical significance. Additionally, both versions demonstrated a high level of empathy, though ChatGPT 4 showed a superior ability to provide clinically acceptable and safe responses.</p><p><strong>Conclusion: </strong>ChatGPT has demonstrated the ability to provide qualified, empathetic, and clear responses to most questions. ChatGPT-4, in particular, offered more satisfactory responses with fewer errors. The tool shows great potential in the therapeutic approach for bariatric surgery patients, but further studies are needed to enhance its safe and effective use by both physicians and patients.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between the Decrease of Perirenal Fat and Hypertension Following Sleeve Gastrectomy: A Single-Center 1-Year Follow-Up Cohort Study.","authors":"Nasser Malekpour Alamdari, Maryam Abbasi, Mahmoud Sadeghi, Yeganeh Farsi, Seyed Hossein Hajimirzaei, Sara Besharat, Seyed Amirhossein Salehi, Amir Mohammad Daei","doi":"10.1007/s11695-025-08296-4","DOIUrl":"https://doi.org/10.1007/s11695-025-08296-4","url":null,"abstract":"<p><strong>Background: </strong>Growing evidence supports the role of visceral fat mass, including perirenal fat (PRF), in obesity-related hypertension. Previous studies have shown that metabolic surgeries can decrease visceral fat mass and PRF. The effectiveness of metabolic surgeries, particularly sleeve gastrectomy, in ameliorating obesity-related hypertension via decreasing the PRF, still needs to be determined.</p><p><strong>Methods: </strong>This prospective cohort study included morbidly obese patients who were candidates for sleeve gastrectomy referred to a tertiary hospital in Tehran. The anthropometric features, lipid profile, serum creatinine, systolic and diastolic blood pressure, and PRF via sonography were recorded before the surgery and compared with the results 12 months later.</p><p><strong>Results: </strong>One year after sleeve gastrectomy, significant improvement was noted in body weight, body mass index, and metabolic indexes such as lipid profile, serum creatinine, systolic and diastolic blood pressure, and PRF (all p < 0.05). Also, a significant association was noted between PRF changes and serum low-density lipoprotein (LDL), triglyceride, and blood pressure (p = 0.03, p = 0.02, and p = 0.02, respectively).</p><p><strong>Conclusions: </strong>Sleeve gastrectomy is associated with a significantly improved anthropometric features, PRF, lipid profile, serum creatinine, and blood pressure. PRF is associated with blood pressure, LDL, and triglycerides and appears independent of weight and BMI changes based on observed correlations.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Efficacy and Safety of Bariatric Surgery in Well-Compensated Liver Cirrhosis: A Systematic Review and Single-Arm Meta-analysis\".","authors":"Shandi Wan","doi":"10.1007/s11695-025-08319-0","DOIUrl":"https://doi.org/10.1007/s11695-025-08319-0","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of Patients Seeking Bariatric Surgery: The Impact of Early Patient-Provider Communication on Bariatric Surgery Utilization.","authors":"Nitin Srinivasan, Jamil Samaan, Nithya Rajeev, Agnes Premkumar, Kelvin Alvarez, Lucy Harvey, Stephanie Nguyen, Ashley Tran, Kamran Samakar","doi":"10.1007/s11695-025-08305-6","DOIUrl":"https://doi.org/10.1007/s11695-025-08305-6","url":null,"abstract":"<p><strong>Introduction: </strong>Bariatric surgery (BS) is an effective and durable long-term treatment for severe obesity, yet less than 1% of eligible patients undergo surgery. Thus, we explored the perceptions and experiences of patients with obesity seeking BS prior to obtaining a referral for surgery.</p><p><strong>Methods: </strong>A survey was prospectively administered to patients who were referred to our institution from March 25, 2023, to May 28, 2024. Questions assessed patients' initial exposure to BS, perceptions of its safety and efficacy, who initiated referral discussions, and whether patients would have considered surgery earlier if prompted by their healthcare provider. Statistical analyses included Chi-square test. Qualitative analysis using thematic analysis was conducted for free-text responses.</p><p><strong>Results: </strong>Out of 327 patients invited, 118 completed the survey (36.1%). The majority of participants (57.9%) initiated discussions about BS with their provider, and 79.7% would have considered BS sooner if approached earlier. Respondents had considered BS for 3.8 years on average (standard deviation = 5.3). The most important contributions of BS for patients were \"improved health\" (94.1%) and \"improved appearance\" (31.6%). The most commonly reported barriers to obtaining a referral included cost (55.1%), followed by safety (45.8%) and efficacy (33.1%) concerns.</p><p><strong>Discussion: </strong>Our findings underscore the importance of proactive and early engagement between providers and patients regarding BS referrals. Addressing safety and efficacy concerns through comprehensive patient education by providers may improve BS referral rates by removing patients' perceived barriers to care. Financial concerns remain a significant barrier to BS utilization and should be further investigated and addressed.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the Enigma of Post-sleeve Differential Liquid Tolerance: A Time-Resolved MRI Study.","authors":"Athar Elward, Ahmad Omar, Ahmed Abdelsalam, Islam Shawali, Mina Makram, Ahmed Refaat","doi":"10.1007/s11695-025-08276-8","DOIUrl":"https://doi.org/10.1007/s11695-025-08276-8","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic sleeve gastrectomy is one of the restrictive bariatric procedures that often impair food and fluid tolerance and negatively impact quality of life as it affects patients' weight loss, hospital stay, and lifestyle.</p><p><strong>Aim: </strong>The objective of this study was to evaluate water and juice tolerance after LSG using dynamic magnetic resonance imaging (MRI) of the stomach to determine the relationship between fluid tolerance and gastric motility.</p><p><strong>Methods: </strong>The prospective cohort study enrolled 17 adult subjects of both sexes, with a body mass index (BMI) greater than 40 kg/m² without comorbidities or 35 kg/m² with comorbidities, who underwent LSG. Patients were monitored for water and juice tolerance, and dynamic MRI imaging for gastric motility patterns was obtained at one and six months postoperatively.</p><p><strong>Results: </strong>More than half of participants (58.8%) reported difficulty tolerating water, while 5.9% of participants expressed early difficulty tolerating juice. After six months, water tolerance improved significantly. Compared to early dynamic MRI, late MRI gastric motility patterns revealed an improvement trend in the form of a significant decrease in antral frequency and an increase in antral velocity, sleeve transit, and contraction height for both water and juice (p < 0.001). Among patients with improved water tolerance (6 patients), late MRI findings were significantly improved compared to their early MRI findings (p < 0.001). Patients' early wave contraction height was significantly different between water and juice at early and late imaging (p < 0.001).</p><p><strong>Conclusion: </strong>Time-resolved gastric MRI is a useful tool to explain the roots of post-LSG differential liquid tolerance. The gastric antrum is the only coordinated and functionally motile part of the gastric sleeve. An overall significantly improved motility pattern trend was achieved by the end of the study, with the increase in antral contraction height being the most consistent component of that trend. Water tolerance improves significantly 6 months after LSG but remains worse than juice tolerance.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}