Updates in Surgery最新文献

{"title":"Comment on: \"The utility of HALP, M-HALP, and the newly developed CANP scores in predicting prognosis of acute appendicitis\".","authors":"Imen Ben Ismail, Mariem Marzouki","doi":"10.1007/s13304-026-02912-3","DOIUrl":"https://doi.org/10.1007/s13304-026-02912-3","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246500","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":"Functional outcomes and recurrence following laparoscopic ventral versus posterior mesh rectopexy for full thickness rectal prolapse.","authors":"Aiman Liaqat, Spogmai Akbar, Andaleeb Ikram, Momina Mustafa, Parsa Mustafa, Zia Ullah, Muhammad Imran Khan, Muhammad Zarin","doi":"10.1007/s13304-026-02902-5","DOIUrl":"https://doi.org/10.1007/s13304-026-02902-5","url":null,"abstract":"<p><p>Full-thickness rectal prolapse (FTRP) significantly reduces quality of life due to the debilitating constipation and fecal incontinence. Laparoscopic ventral mesh rectopexy (LVMR) and laparoscopic posterior mesh rectopexy (LPMR) are two common abdominal approaches globally practiced. However, comparative data from South Asia is still scarce. The purpose of this study was to compare recurrence and functional outcomes after LVMR versus LPMR. A prospective, non-randomized comparative cohort study was carried out at a tertiary care facility, including patients who underwent laparoscopic mesh rectopexy for FTRP between January 2023 and June 2024, followed for 12 months and follow-up was completed in June 2025. Baseline demographics were comparable between groups. The Cleveland Clinic Constipation Score (CCCS) and Wexner Fecal Incontinence Score (FIS) were used to measure functional outcomes. Recurrence at 12 months was the primary outcome. Functional improvement (ΔCCCS, ΔFIS), operative parameters, and perioperative morbidity were secondary outcomes. SPSS version 25 was used to perform statistical analysis, and p < 0.05 was considered statistically significant. Sixty-five patients with comparable baseline demographics were analyzed (LVMR n = 32; LPMR n = 33). 3.1% (n = 1) of LVMR and none of LPMR patients experienced recurrence at 12 months (p = 0.492) with absolute risk difference of 3.1% points (95% CI, - 9.9 to 15.7). Given the single recurrence event, the comparative analysis of recurrence was considered exploratory. The LVMR group had a considerably longer operative time (188.8 ± 7.0 vs. 120.9 ± 10.2 min, p < 0.001). At 12 months, both approaches showed a significant within-group improvement in CCCS and FIS (p < 0.001). Greater improvement in functional scores was shown in LVMR group (ΔCCCS 8.75 ± 1.76 vs. 7.21 ± 1.54, p < 0.001; ΔFIS 6.72 ± 1.53 vs. 5.58 ± 1.58, p = 0.004) than in the LPMR group, with between-group differences of 1.54 and 1.14 points, respectively. The incidence of complications, length of hospital stay, and estimated blood loss did not differ considerably between groups. Our results are consistent with global literature indicating better improvement in functional recovery scores with LVMR, most likely as a result of avoiding posterior rectal mobilization and preserving autonomic nerves. Improved constipation and continence scores support the ventral approach, despite the longer operative time. However, both techniques are safe choices. For FTRP, both LVMR and LPMR are safe and effective techniques. LVMR is associated with greater improvement in functional scores, while no statistically considerable difference in postoperative complications is observed between the groups, while LPMR offers a shorter operative duration. Given the low number of events, recurrence findings are interpreted as exploratory outcome. There is still a need for larger prospective studies.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246513","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: \"Early prediction of severe acute cholecystitis using routine admission parameters: a study of 1,330 patients\".","authors":"Imen Ben Ismail, Mariem Marzouki","doi":"10.1007/s13304-026-02911-4","DOIUrl":"https://doi.org/10.1007/s13304-026-02911-4","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246464","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":"Tumor volume may be a better indicator than diameter for occult lymph node metastasis in patients with clinical stage-1 lung cancer.","authors":"Muhammet Sayan, Ilknur Aytekin Celik, Mahir Fattahov, Bengisu Artiran, Ismail Cuneyt Kurul, Ali Celik","doi":"10.1007/s13304-026-02898-y","DOIUrl":"https://doi.org/10.1007/s13304-026-02898-y","url":null,"abstract":"<p><p>Occult lymph node metastasis (OLM) remains a major clinical challenge in patients with lung cancer despite comprehensive preoperative staging efforts. Although several predictors of OLM, including tumor diameter, metabolic activity, molecular characteristics, and radiomics, have been extensively investigated, the predictive role of tumor volume remains poorly defined. This study aimed to evaluate whether tumor volume, quantified semi-automatically using artificial intelligence (AI)-assisted Synapse 3D software, could predict OLM in patients with clinically early-stage lung cancer. Patients who underwent surgical resection for clinically staged cT1b-cN0M0 lung cancer between 2018 and 2024 were included. Tumor volume was quantified using Synapse 3D software. Associations between tumor volume and OLM were assessed using univariable and multivariable logistic regression analyses. Because tumor diameter and tumor volume may introduce multicollinearity in multivariable models, separate receiver operating characteristic (ROC) curves were generated, and the corresponding areas under the curve (AUCs) were compared using the DeLong test. A total of 248 patients were included, of whom 59 (23.8%) were female. The mean age was 65.4 years. OLM were identified in 10.8%, 4.8%, and 2.0% of patients at the N1, N2a, and N2b nodal stations, respectively. Multivariable logistic regression identified younger age (p = 0.004), greater tumor volume (p = 0.01), and histopathological subtypes other than adenocarcinoma and squamous cell carcinoma as independent predictors of OLM. Tumor diameter, extent of resection, surgical approach, and PET-CT metabolic activity were not significantly associated with OLM. ROC analysis demonstrated that tumor volume had significantly greater discriminatory ability for predicting OLM than tumor diameter (AUC: 69% vs. 58%; DeLong test, p = 0.004). AI-assisted tumor volumetry is an independent predictor of occult lymph node metastasis in patients with clinically early-stage lung cancer.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246474","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":"Indocyanine green fluorescence cholangiography versus intraoperative cholangiography for laparoscopic cholecystectomy: an updated systematic review and meta-analysis of randomized controlled trials.","authors":"Omar Amro, Hasan Al-Chalabi, Rafie Ebrahimi Ghaei, Ahmed Talahmeh, Mohamed S Mohamed","doi":"10.1007/s13304-026-02896-0","DOIUrl":"https://doi.org/10.1007/s13304-026-02896-0","url":null,"abstract":"<p><p>Bile duct injury during laparoscopic cholecystectomy is mainly related to misidentification of extrahepatic biliary anatomy. This systematic review and meta-analysis compared indocyanine green fluorescence cholangiography (ICG-FC) with conventional intraoperative X-ray cholangiography (IOC) for biliary visualization, procedural efficiency, technical success, surgeon satisfaction, and perioperative safety. PubMed, Scopus, Web of Science, and CENTRAL were searched without restrictions. Eligible studies were randomized controlled trials comparing ICG-FC with conventional IOC in adults undergoing laparoscopic cholecystectomy. The primary outcome was successful visualization of extrahepatic biliary anatomy. Secondary outcomes included cholangiography failure, cholangiography duration, total operative time, surgeon satisfaction, choledocholithiasis detection, perioperative complications, morbidity, conversion to open surgery, and bile duct injury. Risk of bias was assessed using the Cochrane RoB 2 tool, and random-effects models were applied. Three RCTs including 494 patients were included. Overall biliary visualization did not differ significantly between ICG-FC and IOC (RR 1.02, 95% CI 0.99-1.07; P = 0.22; I² = 0%), including CBD (RR 1.08, 95% CI 0.99-1.18), cystic duct (RR 1.02, 95% CI 0.96-1.09), critical junction (RR 0.98, 95% CI 0.90-1.07), and CHD visualization (RR 1.01, 95% CI 0.93-1.10). ICG-FC significantly reduced cholangiography failure (RR 0.08, 95% CI 0.01-0.58; P = 0.01) and cholangiography duration (MD - 3.90 min, 95% CI - 5.36 to - 2.44; P < 0.00001). Surgeon usability favored ICG-FC (SMD 0.88, 95% CI 0.09-1.68; P = 0.03), while total operative time (MD - 1.30 min, 95% CI - 6.76 to 4.15; P = 0.64), choledocholithiasis detection (RR 1.29, 95% CI 0.51-3.27; P = 0.59), postoperative complications (RR 0.80, 95% CI 0.22-2.91; P = 0.73), morbidity (RR 1.61, 95% CI 0.43-5.98; P = 0.48), and conversion to open surgery (RR 0.23, 95% CI 0.04-1.36; P = 0.11) were comparable. No bile duct injuries were recorded. ICG-FC provides biliary visualization comparable to IOC while improving technical success and reducing cholangiography duration. Large multicentre randomized controlled trials are required to determine whether these technical advantages reduce bile duct injury.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246467","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":"Beyond keyword mapping: toward more clinically contextualized bibliometric studies of liver xenotransplantation.","authors":"Yi Wang, Jiahong Wang, Ziqiang Dai","doi":"10.1007/s13304-026-02860-y","DOIUrl":"https://doi.org/10.1007/s13304-026-02860-y","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246118","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":"Different intestinal bipartition procedures: early retrospective results from a multicenter Italian experience in 202 patients.","authors":"Giulia Vitali, Laura Agostinelli, Luigi Romeo, Marco Antonio Zappa, Vittorio Corso, Alessandra Sguera, Marco Anselmino, Lorenzo Cinelli, Rosario Bellini, Stefano Olmi, Davide Moioli, Antonio Susa, Angelo Michele Schettino, Stefano Amadori, Antonio Braun, Massimiliano De Palma, Sergio Carandina, Giovanni Fantola, Paolo Bernante, Francesca Balsamo, Cosimo Callari, Beatrice D'Orazio, Giuliano Sarro, Vincenzo Consalvo, Marco Raffaelli, Paolo Gentileschi, Giuseppe Navarra, Fabio Guccione, Amanda Belluzzi, Maurizio De Luca, Andrea Lucchi","doi":"10.1007/s13304-026-02887-1","DOIUrl":"https://doi.org/10.1007/s13304-026-02887-1","url":null,"abstract":"<p><strong>Background: </strong>Sleeve gastrectomy with intestinal transit bipartition (SG-TB) represents an emerging metabolic bariatric strategy designed to enhance ileal stimulation while preserving physiological nutrient absorption. Different technical variants have been developed, but real world data from multicenter national experiences remain limited. This study aimed to evaluate the preliminary outcomes of intestinal bipartition procedures in Italy.</p><p><strong>Methods: </strong>This retrospective multicenter observational study included 202 consecutive patients who underwent Roux-en-Y Transit Bipartition (RYTB), One Anastomosis Transit Bipartition/ Single Anastomosis Sleeve-Ileal bypass (OATB/SASI), or Duodeno-Ileal Transit Bipartition (DITB) between July 2019 and November 2025 across 13 Italian metabolic bariatric centers. Primary outcomes were weight loss expressed as BMI change, percentage of excess weight loss (%EWL), and percentage of total weight loss (%TWL) at 3, 6 and 12 months. Secondary outcomes included weight related disorders resolution, perioperative outcomes, and complications.</p><p><strong>Results: </strong>Mean baseline BMI was 45.7 kg/m². At 12 months, BMI decreased to 31.9 kg/m², with a mean %EWL of 65.7% and %TWL of 30.9%. Primary RYTB achieved superior weight loss compared with conversional OATB (%EWL79.7% vs. 64.7%; %TWL 41.7% vs. 29.5%).At 12 months, remission rates were 58.5% for hypertension, 34.2% for type 2 diabetes (50% improved), 76.1% for OSAS, and 75% for dyslipidemia. Early complications occurred in 9.9% of patients, with major complications (Clavien-Dindo ≥IIIb) in 1.5%. Readmission rate was 2.5%.</p><p><strong>Conclusions: </strong>Intestinal bipartition procedures demonstrated effective weight loss, significant metabolic improvement, and a favorable safety profile in a real world multicenter setting, in our early (12 months) results. Primary procedures achieved more consistent weight loss, although conversional surgery provided clinically meaningful outcomes. Standardization of technical parameters, particularly common channel length, may further optimize results.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246487","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":"Neutrophil-to-lymphocyte ratio as a predictor of severity and adverse outcomes in complicated acute diverticulitis.","authors":"Gustavo Martínez-Mier, Kevin J De Dios-Sanchez, Gustavo A Navarro-Fernandez, Octavio Avila-Mercado, José M Reyes-Ruiz, Miguel A Carrasco-Arroniz, Ofir D Tecalco-Avendaño","doi":"10.1007/s13304-026-02904-3","DOIUrl":"https://doi.org/10.1007/s13304-026-02904-3","url":null,"abstract":"<p><p>Complicated acute diverticulitis (CAD) requires accurate risk stratification to guide emergency management and surgical decision-making. Hemogram-derived inflammatory biomarkers, including the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), may provide rapid and accessible prognostic information. This study evaluated the diagnostic and prognostic utility of these biomarkers compared with the APACHE II score in patients with CAD. This retrospective study included 204 adult patients with CT-confirmed CAD treated at a tertiary referral center in Mexico between March 2022 and December 2024. Admission inflammatory biomarkers, including NLR, PLR, RDW, and WBC count, together with APACHE II score, were analyzed. Primary outcomes included disease severity (abscess versus peritonitis), need for surgery, postoperative complications, and in-hospital mortality. Receiver operating characteristic (ROC) curve analysis and multivariable logistic regression were performed. Most patients presented with severe disease, with peritonitis observed in 86.8% of cases. Mean NLR was significantly higher in patients with peritonitis, those requiring surgery, and non-survivors (p < 0.001). PLR was significantly higher in patients with abscesses (p = 0.008). ROC analysis demonstrated that NLR showed good discriminatory performance for peritonitis (AUC 0.758) and excellent performance for in-hospital mortality (AUC 0.962). In surgically treated patients (n = 177), APACHE II was the strongest independent predictor of major postoperative complications (OR 1.34; p < 0.001), whereas preoperative NLR remained an independent predictor of postoperative mortality (OR 14.54; p = 0.001). NLR is an inexpensive and widely available biomarker with strong prognostic performance in complicated acute diverticulitis. It may assist in early identification of patients at increased risk of severe disease, surgical intervention, and mortality. Combining CBC-derived inflammatory biomarkers with validated severity scoring systems such as APACHE II may improve emergency triage and perioperative risk stratification in CAD.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246478","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":"Single-port versus multi-port robotic complete mesocolic excision for right colon cancer.","authors":"Riccardo Magarini, Pietro Achilli, Guglielmo Niccolò Piozzi, Matteo Origi, Colomba Frattaruolo, Michele Migliorini, Pietro Carnevali, Giovanni Ferrari","doi":"10.1007/s13304-026-02919-w","DOIUrl":"https://doi.org/10.1007/s13304-026-02919-w","url":null,"abstract":"<p><p>Minimally invasive approaches have transformed right cancer surgery, with robotic platforms enhancing challenging techniques like complete mesocolic excision (CME). While traditionally performed using the da Vinci® Multiport system (MP), the introduction of the Single Port™ platform (SP) offers a valuable alternative. This study aims to evaluate the technical feasibility and pathologic surrogates of resection adequacy of robotic right colectomy with CME performed with the daVinci SP® compared to the daVinci Xi® platform in selected patients. From February 2024 to February 2025 consecutive patients who underwent robotic right colectomy and CME either with MP or SP platform were enrolled in the study. The two populations of patients were compared with particular attention to number and location of lymph nodes harvested as a surrogate outcome for oncologic adequacy. From February 2024 to February 2025, 52 consecutive patients were enrolled in the study. There were no differences in population characteristics with the exception for BMI, which was lower in the SP group. Operative times were longer in the SP group. No differences were noticed in either postoperative outcomes such as length of stay (LOS) or complications rate nor in pathological findings, especially in the number of apical lymph node harvested. SP robotic right colectomy with CME appears feasible and achieves pathologic surrogates of resection adequacy comparable to MP surgery in highly selected patients.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246525","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":"Calcium-stimulated calcitonin and procalcitonin in borderline hypercalcitoninemia: histopathologic and nodal correlates in a thyroidectomy cohort.","authors":"Utku Soyaltın, Rukiye Dilara Tekin Uzman, Tuğba Matlım Özel, Hüseyin Karatay, Ilgın Yıldırım Şimşir","doi":"10.1007/s13304-026-02906-1","DOIUrl":"https://doi.org/10.1007/s13304-026-02906-1","url":null,"abstract":"<p><p>Mild basal calcitonin elevation represents a diagnostic gray zone in patients undergoing thyroid surgery for non-medullary thyroid carcinoma (MTC) indications. We evaluated calcium-stimulated calcitonin and procalcitonin kinetics according to final histopathology and nodal status in this setting. This retrospective study included 37 adults with reproducible borderline basal calcitonin elevation (< 50 pg/mL) selected from 577 patients who underwent total thyroidectomy for non-MTC indications between 2021 and 2024. All patients underwent calcium stimulation testing with measurement of calcitonin and procalcitonin at baseline and after stimulation. Biochemical responses were compared with final histopathology. Median basal calcitonin was 13.1 [11.0-16.8] pg/mL and median peak stimulated calcitonin (psCT) was 480 [320-790] pg/mL. Final histopathology showed MTC in seven patients (18.9%), all microcarcinomas, C-cell hyperplasia (CCH) without MTC in nine, and no C-cell pathology in 21. Median psCT was highest in MTC, intermediate in CCH without MTC, and lower in patients without C-cell pathology (820 [640-1040], 460 [310-670], and 360 [270-540] pg/mL, respectively; nominal p = 0.047 for MTC vs CCH). psCT values ≥ 500 pg/mL were observed in 6 of 7 MTC cases compared with 1 of 9 CCH cases without MTC. Central lymph-node metastasis was documented in 3 of 7 MTC patients and was accompanied by numerically higher psCT and fold-rise values. wf45g6 Procalcitonin increment and fold-rise were greater in MTC than in CCH without MTC, but no stable procalcitonin-based threshold or combined rule was identified. Occult micro-MTC may show marked calcium-stimulated calcitonin responses despite mild basal hypercalcitoninemia. These findings are exploratory and do not validate diagnostic or surgical thresholds.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246469","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}