Pediatric Surgery International最新文献

{"title":"Letter to the Editor: Trust demands transparency: a cautionary note on misleading inference in pediatric acute appendicitis imaging meta-analysis.","authors":"Javier Arredondo Montero","doi":"10.1007/s00383-025-06143-2","DOIUrl":"https://doi.org/10.1007/s00383-025-06143-2","url":null,"abstract":"","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"236"},"PeriodicalIF":1.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732674","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":"A systematic review of risk stratification for pediatric appendicitis.","authors":"Mahshid Mortazavi, Alexandra Dimmer, Elena Guadagno, Dan Poenaru, Sherif Emil","doi":"10.1007/s00383-025-06128-1","DOIUrl":"10.1007/s00383-025-06128-1","url":null,"abstract":"<p><strong>Purpose: </strong>Disease risk stratification is essential for clinical decision-making, prognostication, and outcomes reporting. Pediatric appendicitis is typically described and treated as a binary entity of simple versus perforated, ignoring the wide variation in its presentation and outcomes. We performed a systematic review to assess and synthesize the available literature on risk stratification for pediatric appendicitis.</p><p><strong>Methods: </strong>From inception to July, 2024, a comprehensive search of ten databases was conducted without language restrictions. We included any study that stratified pediatric appendicitis into three or more risk groups based on outcomes, using clinical, laboratory, imaging, surgical, or histopathologic criteria, or any combination of the five. Two independent reviewers performed the initial screening, with conflicts adjudicated by two additional reviewers. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>Of 4,332 studies screened, 64 were selected for full-text evaluation, and seven met the inclusion criteria. The only prospective cohort study utilized a pediatric perforated appendicitis grade assigned at operation. Of the 6 retrospective studies, two employed the American Association for the Surgery of Trauma (AAST) classification, one described a surgeon-reported categorization, one used a pathology-defined appendicitis severity scale, and two multicenter studies used a set of binary (present or absent) findings. In all studies, increased postoperative infectious complications and hospital stays were seen in the higher-risk categories.</p><p><strong>Conclusions: </strong>Few pediatric appendicitis studies report risk-stratified outcomes with no widely accepted or utilized risk stratification system. A universal pediatric appendicitis grade is needed to improve clinical care, prognostication, benchmarking, outcomes reporting, and resource allocation.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"234"},"PeriodicalIF":1.6,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718298","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":"Laparoscopically assisted versus open colostomy for anorectal malformations: a comparison of postoperative outcomes.","authors":"G Axelsson, A Gunnarsdóttir, T Wester, A Löf Granström","doi":"10.1007/s00383-025-06108-5","DOIUrl":"10.1007/s00383-025-06108-5","url":null,"abstract":"<p><strong>Purpose: </strong>Colostomy is a common procedure in neonates with anorectal malformations (ARM) but carries a risk of complications, prompting the development of a laparoscopically assisted approach to minimize them. This study aimed to compare postoperative outcomes in ARM patients undergoing laparoscopically assisted versus open colostomies.</p><p><strong>Methods: </strong>Medical records of all newborns with ARM who underwent colostomy at Karolinska University Hospital between 2012 and 2022 were retrospectively reviewed. Patients were grouped based on whether the colostomy was laparoscopy-assisted or fashioned through a limited open incision at the stoma site. Postoperative outcomes, including time to first oral feeding, hospital stay, and complications according to Clavien-Madadi, were compared.</p><p><strong>Results: </strong>A total of 44 patients were included, of whom 14 underwent laparoscopically assisted colostomy. Among all patients, the median time to first oral feeding was zero days and the median hospital stay was eight days, with no significant group differences. Postoperative complications classified as Clavien-Madadi ≥ IB occurred in 2 patients (14%) in the laparoscopic group and 7 (23%) in the open colostomy group (p = 0.6). No significant differences in complication severity were observed.</p><p><strong>Conclusion: </strong>Laparoscopically assisted colostomy has a similar risk of postoperative complications as open colostomy in patients with ARM.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"232"},"PeriodicalIF":1.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel CTNNB1 gene mutations reveal critical pathogenic mechanisms in pediatric hepatoblastoma.","authors":"Sourabh Kumar, Jyoti Sharma, Himani Pandey, Vishesh Jain, Anjan Kumar Dhua, Devendra Kumar Yadav, Devi Lal, Prabudh Goel","doi":"10.1007/s00383-025-06116-5","DOIUrl":"10.1007/s00383-025-06116-5","url":null,"abstract":"<p><strong>Background: </strong>Hepatoblastoma (HB) is the most common primary malignant liver tumor in children, with alterations in the Wnt/β-catenin signaling pathway implicated in up to 90% of cases. The CTNNB1, which codes for β-catenin protein, plays a crucial role in this pathway, but its mutation landscape across diverse populations requires further investigation.</p><p><strong>Objectives: </strong>To analyse and characterize the genetic variations in the CTNNB1 across three geographically diverse cohorts of hepatoblastoma patients and understand their potential pathogenic mechanisms.</p><p><strong>Methods: </strong>The exome data for 54 hepatoblastoma tissue samples was subjected to quality control and alignment to GRCh38. SNVs were identified using GATK/Mutect2 and annotated using multiple databases. CTNNB1 gene variants were filtered and analyzed using cBioPortal, CONSURF 3.0, STRING database, and VarElect for comprehensive molecular and phenotypic analysis.</p><p><strong>Results: </strong>CTNNB1 mutations were identified in 88.9% of patients, with 21 unique variants found in 24 patients post-filtering. Exon 3 was most frequently affected, with 17 unique mutations present in 91.66% of mutation-positive patients. The most common variants were c.101G > T (p.Gly34Val), c.98C > T (p.Ser33Phe), and c.98C > A (p.Ser33Tyr). Novel mutations were identified at positions S29 and I35, while additional variations were found in exons 4, 7, 10, and 13.</p><p><strong>Conclusion: </strong>This study identified significant CTNNB1 genetic variations in hepatoblastoma, confirming exon 3 as a critical mutational hotspot. The findings enhance our understanding of HB pathogenesis and suggest potential therapeutic targets, particularly in the Wnt/β-catenin signaling pathway. These mutations may serve as valuable diagnostic and prognostic biomarkers for personalized treatment approaches in pediatric hepatoblastoma.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"233"},"PeriodicalIF":1.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718300","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":"Protocolized management of intussusception in children: optimizing pneumatic reduction outcomes.","authors":"Anas Shikha, Mashal Ahmed, Zahraa Zaghloul, Khalid Eltaeb, Janice Wong","doi":"10.1007/s00383-025-06138-z","DOIUrl":"10.1007/s00383-025-06138-z","url":null,"abstract":"<p><strong>Background: </strong>Intussusception is the most common cause of intestinal obstruction in children, requiring timely management to avoid serious complications. Pneumatic reduction is widely accepted as the first-line non-operative treatment, though its success may be influenced by factors such as prolonged symptom duration, intussusception type, and advanced intussusceptum location. The role of adjunct therapies, including corticosteroids, remains uncertain. This study aimed to evaluate the outcomes of a standardized modified pneumatic reduction (MPR) protocol implemented at a single national pediatric center.</p><p><strong>Materials and methods: </strong>A retrospective review was conducted of 92 admissions involving 79 patients treated between May 2016 and October 2024. The MPR protocol employed a manual sphygmomanometer-based system with incremental pressure adjustments and selective intravenous hydrocortisone for specific indications. Standardized documentation and follow-up protocols were applied.</p><p><strong>Results: </strong>MPR achieved a 99% success rate, with complications limited to one case of pneumoperitoneum (1%) and self-limiting mild desaturation in 6% of cases. Early and delayed recurrence rates were 16 and 10%, respectively. Factors traditionally considered limiting did not preclude successful reduction. In the subgroup of failed attempts or recurrent cases, hydrocortisone use was associated with an increase in the proportion of 'easy' reductions from 47 to 83% (p = 0.038), suggesting a potential benefit warranting further investigation.</p><p><strong>Conclusion: </strong>A structured, protocolized MPR approach resulted in high success and low complication rates, even in challenging scenarios. These findings support the value of standardized non-operative management and suggest a possible targeted role for hydrocortisone in selected cases.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"231"},"PeriodicalIF":1.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718301","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":"Pediatric surgery in Burkina Faso: capacity, gaps, and challenges.","authors":"Sophie Inglin, Abou Coulibaly, Yasmine Yousef, Anata Bara, Seni Kouanda, Barbara E Wildhaber","doi":"10.1007/s00383-025-06130-7","DOIUrl":"10.1007/s00383-025-06130-7","url":null,"abstract":"<p><strong>Purpose: </strong>Burkina Faso faces challenges in pediatric surgical care, with apparent gaps in human resources, infrastructure and education. However, no quantitative analysis has been performed to date. This study aims to evaluate the capacity for pediatric surgery across Burkinabé healthcare facilities.</p><p><strong>Methods: </strong>This study is a cross-sectional descriptive analysis conducted in 26 healthcare facilities in Burkina Faso, including first-, second-, and third-level hospitals as well as private clinics. It used the Global Assessment in Pediatric Surgery (GAPS) tool to evaluate five domains: human resources, material resources, outcomes, accessibility, and education.</p><p><strong>Results: </strong>The study showed significant gaps in pediatric surgical care: A full-time pediatric surgeon is appointed in 7/26 facilities. Specialized infrastructure for pediatric surgery is limited: Operating rooms dedicated to pediatric surgery are observed in 2/6 tertiary hospitals, minimally invasive surgery is available in 3/26 facilities. Education programs were deficient: Continuing medical education to > 50% of professionals is offered in 1/26 facility. 22/26 facilities provided follow-up care for more than 50% of their patients.</p><p><strong>Conclusion: </strong>Burkina Faso faces major challenges in pediatric surgical care, particularly related to human and material resources as well as training. These issues must be addressed in the upcoming national pediatric surgery strategy to ensure equitable access to quality care across the country.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"230"},"PeriodicalIF":1.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative outcomes of robotic-assisted vs. laparoscopic pull-through surgery in pediatric Hirschsprung's disease: a systematic review and meta-analysis.","authors":"Carla Isabella Miret Durazo, Paloma Frei, Stephanie Gail Giray Go, Rafeeqa Binte Ameenuthin, M J Marie Caragon Baptista, Francesca Gabriela Ocana Diaz, Yadelys Rodriguez Reyes, Sylvia Oluwafunmilayo Ejinaka, Abdulrahman Abdulkarim Shawish, Evelyn Saavedra Reyna, Saimuralidhar S Srinivasan, Stephani Carolina Salvatierra Moreno, Victor Sebastan Arruarana","doi":"10.1007/s00383-025-06137-0","DOIUrl":"10.1007/s00383-025-06137-0","url":null,"abstract":"<p><p>Hirschsprung's disease (HSCR) is a congenital bowel disorder caused by absent enteric ganglion cells, often in neonates with intestinal obstruction. Minimally invasive surgical resection is the standard treatment. Robotic-assisted pull-through surgery (RAS) offers improved precision, but comparative data with laparoscopic-assisted surgery (LAS) is limited. This systematic review and meta-analysis evaluated postoperative outcomes between RAS and LAS in pediatric HSCR. Literature search was performed in PubMed/MEDLINE, Web of Science, Scopus, EMBASE, CINAHL, and Cochrane Library, following PRISMA guidelines. Random-effects meta-analysis with 95% confidence interval (CI) was conducted. Protocol was preregistered on PROSPERO (CRD420251033648). Four studies involving 291 pediatric patients (124 RAS, 167 LAS) were included. RAS demonstrated significantly lower blood loss (MD = - 2.66; 95% CI - 4.54 to - 0.80; p < 0.01) and higher hospitalization expenses (MD = 44,922.20; 95% CI 43,592.28-46,252.12; p < 0.01). LAS presented shorter postoperative feed times (MD = 1.00; 95% CI 0.16-1.84; p = 0.02). No significant differences were observed in other postoperative outcomes. RAS appears to be a safe alternative to LAS in pediatric HSCR. However, no definitive clinical advantage of RAS is confirmed. Further studies are warranted to clarify its role in pediatric colorectal surgery.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"228"},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699155","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":"Retained gallstones after laparoscopic cholecystectomy in kids: a systematic review.","authors":"Mohammed Al Blooshi, Humaid Al Zaabi, Fatima Al Harmoodi, Mariam Al Shamsi","doi":"10.1007/s00383-025-06113-8","DOIUrl":"10.1007/s00383-025-06113-8","url":null,"abstract":"<p><p>Pediatric laparoscopic cholecystectomy (LC) is increasingly common, but the incidence and clinical implications of retained or spilled gallstones in children remain incompletely characterized. We performed a systematic review of MEDLINE, Embase, Scopus, Web of Science, Google Scholar, and gray literature through 2024, including 12 studies (1057 pediatric LCs). Gallbladder perforation with visible stone spillage occurred in 4.3% (95% confidence interval [CI] 2.9-6.1%) of cases, and clinically significant retained-stone complications-primarily intra-abdominal or port-site abscesses and common bile duct stones-were observed in 1.7% (95% CI 0.9-3.0%). All such complications were successfully managed using endoscopic retrograde cholangiopancreatography, laparoscopic, or percutaneous approaches. Although most spilled stones remain asymptomatic, late presentations up to two years after LC underscore the importance of meticulous retrieval, explicit documentation of spillage, and early imaging for suspicious postoperative symptoms. Existing evidence is constrained by small sample sizes, retrospective designs, and limited follow-up. Nevertheless, it suggests that while gallstone spillage and retention are uncommon in pediatric LC, they can lead to significant morbidity if overlooked. Larger, prospective multicenter registries with standardized definitions, extended follow-up, and robust outcome measures are warranted to clarify true incidence, identify modifiable risk factors, and refine preventive strategies, ultimately improving safety for children undergoing cholecystectomy.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"229"},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative quantitative analysis of intestinal perfusion by ICG fluorescence in Hirschsprung disease: a single-center retrospective cohort study.","authors":"Zhen Zhang, Ya Gao, Ya Ma, Ruijie Zhou, Yong Chen, Long Li, Qian Jiang, Qi Li","doi":"10.1007/s00383-025-06068-w","DOIUrl":"https://doi.org/10.1007/s00383-025-06068-w","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative complications at the coloanal anastomosis site following surgery for Hirschsprung disease (HSCR) can significantly impact bowel function recovery in children. Indocyanine green (ICG) fluorescence imaging provides a real-time, quantitative assessment of perfusion, potentially improving surgical outcomes. This study aims to evaluate the effectiveness of an ICG-based quantitative perfusion analysis strategy compared to conventional visual assessment in determining anastomotic site selection.</p><p><strong>Methods: </strong>This single-center retrospective study included consecutive patients with histologically confirmed HSCR who underwent surgery between January 2023 and January 2024. Following vascular arcade ligation and transanal pull-through, anastomotic site selection was guided either by conventional visual assessment (Visual Group) or ICG fluorescence angiography with quantitative perfusion analysis (ICG Group). We chose the specific ICG perfusion parameters (Fmax > 30 AU, Tmax < 30 s) as safe anastomotic site thresholds. Postoperative complications, functional outcome and perianal ultrasound findings were assessed during follow-up.</p><p><strong>Results: </strong>A total of 167 patients were included, with 34 in the ICG Group and 133 in the Visual Group. Both groups had comparable baseline characteristics. While no significant differences were observed in postoperative bowel movement recovery or major anastomotic complications, perianal ultrasound at 5-7 days postoperatively revealed significantly reduced anastomotic inflammation in the ICG Group. Follow-up analysis showed that the ICG Group had a shorter hospital stay (7 days, IQR 7-8 vs. 8 days, IQR 7-10.5, p = 0.003), as well as a higher percentage of HAEC-free patients (78.1% for ICG vs. 56.8% for Visual) compared to the Visual Group.</p><p><strong>Conclusion: </strong>Quantitative ICG fluorescence imaging provides a more precise and objective approach for anastomotic site selection in HSCR surgery. This strategy may reduce postoperative anastomotic inflammation and HAEC. Further studies are needed to validate its long-term clinical benefits and establish standardized protocols for pediatric colorectal surgery.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"227"},"PeriodicalIF":1.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691153","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":"Comparison of the current characteristics and management of congenital biliary dilatation with and without a fetal diagnosis: report of 231 consecutive cases from the Kyushu Pediatric Surgery Study Group in Japan over the past decade.","authors":"Masakazu Murakami, Keisuke Yano, Shohei Maeda, Takeshi Shirai, Yusuke Yamane, Taichiro Kosaka, Takafumi Kawano, Makoto Hayashida, Toshiharu Matsuura, Hiroto Eto, Motofumi Torikai, Yukihiro Tatekawa, Takeshi Yamanouchi, Taizo Hibi, Tatsuro Tajiri, Satoshi Ieiri","doi":"10.1007/s00383-025-06136-1","DOIUrl":"10.1007/s00383-025-06136-1","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to investigate and to compare the current characteristics and management of congenital biliary dilatation (CBD) with and without fetal diagnosis (FD) based on a multicenter study at all institutions in Kyushu, Japan.</p><p><strong>Methods: </strong>A regional multicenter study was conducted among the institutions affiliated with the Kyushu Pediatric Surgery Study Group. Patients with CBD who underwent definitive surgery between 2014 and 2023 were enrolled.</p><p><strong>Results: </strong>All 28 affiliated institutions joined this multicenter study. There comprised 231 cases (Date collection rate: 100%), including 35 cases (15.2%) with an FD. Compared to cases without an FD, cases with an FD were significantly more frequently recognized in type Ia (p < 0.01), significantly less frequently recognized in type Ic (p = 0.04), and IV-A (p < 0.01), and showed a significantly lower frequency of preoperative cholangitis (p < 0.01) and pancreatitis (p < 0.01). Cases with an FD had significantly shorter operative times (p < 0.01). There were no significant differences in the frequency of postoperative and late postoperative complications between the patients with and without an FD.</p><p><strong>Conclusion: </strong>CBD cases with an FD were more likely to be type Ia and less likely to have preoperative symptoms than those without an FD, with a comparable risk of postoperative complications.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"224"},"PeriodicalIF":1.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}