Journal of Robotic Surgery最新文献

{"title":"Very long-term outcomes of robotic mesh sacrocolpopexy for pelvic organ prolapse repair.","authors":"Sonia Guérin, Evan Suzman, Feras Alhalabi, Kevin Lutz, Philippe Zimmern","doi":"10.1007/s11701-024-02185-1","DOIUrl":"https://doi.org/10.1007/s11701-024-02185-1","url":null,"abstract":"<p><p>To assess the very long-term functional outcomes and complications of robot-assisted sacrocolpopexy (RASC) at our institution where this robotic technology for pelvic organ prolapse (POP) repair has been available since 2006. A retrospective review of a cohort of women who underwent a RASC was performed by an investigator not involved in the clinical care of these patients. Women with no electronic medical record follow-up in the last 2 years were contacted by telephone. The primary outcome was RASC success defined as (1) no self-report of vaginal bulge, (2) no prolapse beyond the hymen (POP-Q > 0), and (3) no retreatment for prolapse (surgery, pessary). Postoperative symptomatic urinary incontinence (UI), anorectal dysfunction, dyspareunia and any late complication were secondary outcomes. Of 100 women who underwent RASC between 2007 and 2018, 79 patients with a median age of 66 years (IQR 58-71) were included. Median follow-up was 69 months (28-117), with a last visit more than 5 years postoperatively in 48 patients and more than 10 years in 19 patients. A total of 59 patients (75%) met the definition of success. A bothersome vaginal bulge was reported in 18 patients (23%), prolapse beyond the hymen was observed in 12 patients (16%), and further surgery for POP was performed in 9 patients (12%). Twenty-three patients reported postoperative UI (32%) and 21 reported postoperative anorectal dysfunction (39%). RASC provided good long-term results with an unpredictable risk of recurrence independent of the timeline.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"25"},"PeriodicalIF":2.2,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819725","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 and meta-analysis comparing the short-term efficacy of the KangDuo surgical robot with the da Vinci robotic system in radical prostatectomy.","authors":"Zhi-Kai Dai, Jun-Min Wang, Qi-Min Zhang, Ping Liang, Ting-Ting Zhou, Tai-Ping Leng, Liang Wang, Yao-Yu Zhang, Jian-Wei Zhang, You-Guang Zhao, Sha-Dan Li","doi":"10.1007/s11701-024-02188-y","DOIUrl":"10.1007/s11701-024-02188-y","url":null,"abstract":"<p><p>To determine the efficacy and adverse consequences between KangDuo and Da Vincii surgical robotic systems in facilitating radical prostatectomy. All the papers, that were included in the current analysis, were identified with PubMed, Embase, and the Cochrane Library through October 1, 2024. To make the comparison easier, only the English-language articles have been used for the analysis and only those focusing on comparing the use of the KangDuo and da Vinci robotic systems in radical prostatectomy were used. There are several avenues of bias when considering articles to include, when selecting the articles for this study to adopt the RCTs and cohort studies and excluding the others, the bias selection targeted was minimal. For the systematic review, 1 cohort study was found as well as 2 RCTs were found that involved 150 adult patients assigned to undergo urological surgery. Of those, 76 patients operated by the Kang Duo robotic system, and the remaining 74 patients operated by the Da Vinci system. In conclusion from this study, it was noted that though there was an increase in the operative time used in the KangDuo system, the estimated blood loss, number of days needed to stay in hospital, and the incidences of postoperative complications were comparable to the other system. Compared to the da Vinci robotic system, the KangDuo robotic system, while associated with longer operative times for radical prostatectomy, showed no significant difference in perioperative or short-term outcomes. In addition, the KangDuo system is more cost-effective and easier to implement in developing countries or other regions. However, further high-quality studies are needed to confirm these findings.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"21"},"PeriodicalIF":2.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814640","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":"Perceptions and attitudes regarding robotic total hip arthroplasty: a patient stakeholder survey.","authors":"Hassaan Abdel Khalik, Asher Selznick, Kamal Bali, Yasaman Amini, Isabelle Tate, Thomas J Wood","doi":"10.1007/s11701-024-02172-6","DOIUrl":"https://doi.org/10.1007/s11701-024-02172-6","url":null,"abstract":"<p><p>To describe the attitudes and preferences of patients pertaining to robotic-assisted total hip arthroplasty (RA-THA) with the long-term objective of designing a prospective randomized-controlled trial (RCT) to evaluate the efficacy of RA-THA compared to conventional technique. A cross-sectional survey of patients attending an outpatient high-volume academic arthroplasty clinic chosen was administered from December 2023 to May 2024. The survey comprised 31 items including patient demographic, patient reported factors of significance and perceptions surrounding RA-THA. Ninety-seven patients completed the survey with a mean age of 67.5 ± 9.1 years and with 63% of patients being female. The majority of respondents were not at all familiar with RA-THA (69%). Common perceptions of RA-THA compared to conventional technique included a smaller incision (41%), lower chance of developing infection (47%), shorter length of surgery (41%), less blood loss (41%), lower cost (22%), shorter length of stay (30%), more precise implant positioning (46.8%), lower post-operative pain (29%), and lower post-operative complications (36%). Very important outcomes to be assessed in future investigations included post-operative range of motion (91%), implant longevity (91%), dislocation risk (90%), post-operative pain (89%), and infection risk (87%). Patient familiarity with robotic-assisted total hip arthroplasty is low. Patient perceptions regarding RA-THA compared to conventional technique are favorable, despite limited evidence to date. Important factors to be assessed in future RCTs include range of motion, implant longevity, dislocation risk, and infection risk. Findings of this study can inform a clinically relevant RCT assessing RA-THA compared to conventional technique.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"22"},"PeriodicalIF":2.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814596","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":"Complete hepatic caudate lobe resection: is robotic approach safe? Report from experienced centers.","authors":"Greta Donisi, Emanuele Doria, Gemma Bosch, Fernando Burdio, Celine De Meyere, Mathieu D'Hondt, Fabrizio Di Benedetto, Rosalinda Filippo, Annarita Libia, Victor Lopez-Lopez, Paolo Magistri, Riccardo Memeo, Patricia Sanchez-Velazquez, Marcello Giuseppe Spampinato, Ricardo Robles-Campos, Iswanto Sucandy, Benedetto Ielpo","doi":"10.1007/s11701-024-02162-8","DOIUrl":"10.1007/s11701-024-02162-8","url":null,"abstract":"<p><p>Minimally invasive liver surgery has become widely accepted as a safe and effective approach, especially with experienced surgeons. Robotic hepatectomy may offer significant benefits in challenging procedures like caudate lobe resection. The caudate lobe's intricate anatomy and deep-seated location make its resection particularly challenging, with limited reports on minimally invasive techniques. The aim of this study was to assess the feasibility and safety of robotic isolated complete caudectomy and to provide a detailed description of the different technical approaches available. This retrospective multicenter study was conducted across eight experienced hepatobiliary robotic surgery centers between June 2020 and March 2024. All patients who underwent elective RICC during this period were included. Data were prospectively collected and retrospectively analyzed, focusing on demographics, intraoperative variables, postoperative outcomes, and histopathological results. The primary outcome was the feasibility and safety of the robotic approach. The study included 42 patients. The median (IQR) operative time was 180 (125-245) min, with a median estimated blood loss of 30 (0-100) ml. There were no conversions to open surgery and only one severe complication (Clavien-Dindo ≥ 3) occurred. No postoperative mortality was observed, and all resections for malignant lesions achieved R0 margins. The median time to flatus was 1 (1-1) day, time to solid diet was 1 (1-2) days, and the median length of stay was 3 (2-4) days. RICC is a feasible and safe procedure, demonstrating significant benefits in operative efficiency and patient recovery. However, further research with larger, prospective multicenter studies is necessary to confirm these findings and assess long-term outcomes.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"23"},"PeriodicalIF":2.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814654","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":"Understanding fundamental differences in symptomatic outcomes of hiatal versus paraoesophageal hernia robotic repairs.","authors":"Arham Aslam, Michal Hubka, Joel Sternbach, Madhan Kuppusamy","doi":"10.1007/s11701-024-02182-4","DOIUrl":"https://doi.org/10.1007/s11701-024-02182-4","url":null,"abstract":"<p><p>Hiatal hernia (HH), or type I paraoesophageal hernias (PEH), can commonly be grouped along with types II-IV PEHs. The fundamental operation performed for repair is similar for all types. We question whether the clinical outcomes following surgical repair differ. The objective of this study is to determine the differences in clinical outcomes when comparing robotic-assisted surgical repair of HH versus types II-IV PEHs. This is a retrospective study analyzing 602 consecutive patients that underwent robotic-assisted repair of a PEH between August 2018 and June 2024. Data were retrieved from an IRB-approved database (IRB21-014). Tertiary referral center. Eligibility criteria included patients with objective findings of a PEH on diagnostic testing. 184 patients were excluded due to: emergent operation, repeat operations, conversion to open operation, patients pending follow-up, and patients lost to follow up. Patient demographics were consistent with a population-based sample. All patients underwent robotic-assisted laparoscopic PEH repair with a fundoplication using the Da Vinci Xi robotic system (Intuitive Surgical, Sunnyvale, CA). No mesh implantation was used. The primary study outcome was post-operative symptomatic improvement when comparing HH repairs versus types II-IV PEH repairs. Secondary outcomes included other perioperative outcomes. The hypothesis was formulated before data collection started. Patients in the HH cohort showed significant reflux symptom improvement postoperatively (98% vs 12.2%, p < 0.01). PEH patients also showed similar improvements in reflux symptoms (84.8% vs 25%, p < 0.01). Symptomatic improvement of dysphagia was found to be significant only in the PEH cohort (54% vs 17.8%, p < 0.01). HHs and PEHs are two distinct entities that present with different symptoms; however, the fundamental operation is similar. Symptomatic outcomes differ between the two patient populations, even with the same surgical management.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"24"},"PeriodicalIF":2.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814600","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":"An institutional analysis of hospital readmission following a robotic pancreaticoduodenectomy.","authors":"Denis Gratsianskiy, Dharti Patel, Iswanto Sucandy, Tara M Pattilachan, Maria Christodoulou, Alexander Rosemurgy, Sharona B Ross","doi":"10.1007/s11701-024-02186-0","DOIUrl":"https://doi.org/10.1007/s11701-024-02186-0","url":null,"abstract":"<p><p>This study sought to identify the primary reasons for hospital readmissions and examine patient outcomes and associated costs following readmission after robotic pancreaticoduodenectomy. We conducted a retrospective analysis of 435 patients who underwent robotic pancreaticoduodenectomy between 2012 and 2024. Readmitted patients within 30 days post-surgery were compared to non-readmitted patients using Student's t-test and Fisher's exact test. Data are presented as median (mean ± SD). In the study cohort, 86 patients (20%) were readmitted within 30 days after surgery. No significant differences were found in patient demographics or outcomes. The most common causes for readmission included insufficient patient education (n = 18), infection (n = 16), and gastrointestinal bleeding (n = 13). The readmitted cohort had significantly higher costs at $40,452 (± 30,724) compared to $31,438 (± 31,546.2) for non-readmitted patients (p < 0.001). Median survival was similar between the two groups (36 vs. 34 months, p = 0.88). Although some readmissions are inevitable, this study provides compelling evidence that inadequate patient education is a primary contributor to increased healthcare costs. The lack of sufficient education appears to have no mitigating effect on patient outcomes. Implementing a proactive, thorough patient education approach, combined with improved emergency department awareness, presents a promising strategy for reducing costly readmissions.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"20"},"PeriodicalIF":2.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807722","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":"Predictive model of the surgical difficulty of robot-assisted total mesorectal excision for rectal cancer: a multicenter, retrospective study.","authors":"Mingyu Han, Shihao Guo, Shuai Ma, Quanbo Zhou, Weitao Zhang, Jinbang Wang, Jing Zhuang, Hongwei Yao, Weitang Yuan, Yugui Lian","doi":"10.1007/s11701-024-02180-6","DOIUrl":"10.1007/s11701-024-02180-6","url":null,"abstract":"<p><p>Rectal cancer robotic surgery is becoming more and more common, but evidence for predicting surgical difficulty is scarce. Our goal was to look at the elements that influence the complexity of robot-assisted total mesorectal excision (R-TME) in the medical care of middle and low rectal cancer as well as to establish and validate a predictive model on the basis of these factors. Within this multicenter retrospective investigation, 166 consecutive patients receiving R-TME between January 2021 and December 2022 with middle and low rectal cancer were included and categorized according to the median operation time. A nomogram was created to forecast the procedure's complexity after variables that could affect its difficulty were found using logistic regression analysis. Using R software, a total of 166 patients were randomly split into two groups: a test group (48 patients) and a training group (118 patients) at a ratio of 7 to 3. The median operation time of all patients was 207.5 min; patients whose operation time was ≥ 207.5 min were allocated to the difficult surgery group (83 patients), and patients whose operation time was < 207.5 min were allocated to the nondifficult surgery group. Multivariate analysis revealed that body mass index (BMI), the gap between the tumor and the anal verge and the posterior rectal mesenteric thickness were independent predictors of surgical duration. A clinical predictive model was created and assessed employing the above independent predictors. The results of the receiver operating characteristic (ROC) analysis revealed the adequate discriminative ability of the predictive model. Our study revealed that it is feasible to predict surgical difficulty by obtaining clinical and magnetic resonance parameters for imaging (the gap between the anal verge and the tumour, and posterior mesorectal thickness), and these predictions could be useful in making clinical decisions.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"19"},"PeriodicalIF":2.2,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795669","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":"A systematic review and meta-analysis comparing robotic-assisted percutaneous screw fixation and conventional surgical techniques for acetabular fractures.","authors":"Hao-Zhong Zhu, Di-Ge Li, Yu-Fei Li, Wan-Yu Xu, Ge Chen","doi":"10.1007/s11701-024-02177-1","DOIUrl":"10.1007/s11701-024-02177-1","url":null,"abstract":"<p><p>The objective of this comprehensive review and meta-analysis was to evaluate the effectiveness of robot-aided percutaneous screw fixation versus traditional surgical techniques in managing acetabular fractures. We plan to carry out an exhaustive exploration of certain databases (PubMed, CNKI, Embase, and Cochrane Library) to find studies that have been published since the beginning of these databases until August 2024, focusing on patients with acetabular fractures. These studies will compare the efficacy of robot-assisted percutaneous screw fixation with conventional surgical methods. Both English and Chinese literature will be included. We will adhere strictly to the predefined inclusion and exclusion criteria, with a focus on randomized controlled trials and cohort studies. Review Manager 5.4.1 will be utilized for the execution of data analysis. The ROBINS-I instrument will be used to evaluate the bias risk in Not-RCTs. The final analysis included 6 retrospective cohort studies, encompassing a total of 168 patients, with 83 undergoing robot-assisted percutaneous screw fixation and 85 receiving conventional surgery. The results indicated that patients treated with robot-assisted percutaneous screw fixation had shorter OT, fewer intraoperative fluoroscopy instances, and fewer adjustments of guide pins compared to those receiving conventional surgery. However, no significant differences were observed between the two treatment methods in terms of Modified Postel Merle D'Aubigne scores and EBL. The use of robots in percutaneous screw fixation has been demonstrated to be a secure and efficient method for managing acetabular fractures. Compared to conventional ORIF or free-hand screw fixation, this robotic-assisted technique offers significant advantages, including reduced operation time, lower IFF, and fewer guide wire adjustments.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"17"},"PeriodicalIF":2.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773622","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 impact of robotic surgery on the treatment of benign esophageal and gastric disease: early experience of a specialized unit.","authors":"Konstantinos Saliaris, Ioannis Karikis, Eugenia Mela, Sofia Katsila, Eleni Kitsou, Spyridon Smparounis, Dimitrios Linardoutsos, Dimitrios Theodorou, Tania Triantafyllou","doi":"10.1007/s11701-024-02176-2","DOIUrl":"https://doi.org/10.1007/s11701-024-02176-2","url":null,"abstract":"<p><p>Laparoscopic surgery is a well-established approach in the surgical treatment of reflux, hiatal hernia and esophageal motility disorders such as achalasia. Robotic platforms have only recently been incorporated in surgery for esophageal motility disorders and their exact value remains to be determined. In the present study, we present the preliminary results of our early experience with a case series of benign upper gastrointestinal diseases treated using the robotic system in our department. Data on all consecutive patients undergoing surgery for benign upper gastrointestinal tract (UGI) disease during the last 5 years (01/2029-12/2023) was prospectively collected and retrospectively reviewed. All patients attended regular follow-up appointments. Patients with relapse or deterioration of their symptoms were referred for objective testing using high-resolution manometry and/or 24-h impedance pHmetry. A total of 34 patients were included in our series. Fourteen patients with achalasia underwent robotic Heller myotomy and modified Dor fundoplication, sixteen patients underwent hiatal hernia repair with fundoplication and four patients had a Nissen fundoplication for reflux esophagitis. The median postoperative Eckardt score of the patients treated for achalasia was 2 and a median GERD score of 1 was recorded for patients treated for reflux. Two patients with achalasia were evaluated with manometry due to temporary symptom relapse. The manometric findings were unremarkable. The incorporation of the robotic approach in the surgical treatment of benign UGI diseases is safe and feasible with excellent perioperative and postoperative functional results. Further experience and investigation will allow for reliable comparison to the laparoscopic approach.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"18"},"PeriodicalIF":2.2,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773632","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":"Chinese expert consensus on transoral vestibular approach robotic thyroidectomy and parathyroidectomy (version 2024).","authors":"Qingqing He, Wen Tian, Ping Wang, Xudong Wang","doi":"10.1007/s11701-024-02173-5","DOIUrl":"https://doi.org/10.1007/s11701-024-02173-5","url":null,"abstract":"<p><p>The transoral robotic thyroidectomy (TORT) has been increasingly adopted for minimally invasive thyroid surgery and it has proved to have better cosmetic results and comparable surgical outcomes with open operations. Most reports on TORT are case series, or single center, small-sample controlled, retrospective studies, and clinical guidelines have not been established so far. To better promote the standardized implementation and widespread adoption of TORT in China, the expert panel have organized thyroid minimally invasive surgery experts and some robotic thyroidectomy experts in China jointly formulate the Chinese expert consensus on transoral vestibular approach robotic thyroidectomy and parathyroidectomy (2024 edition) based on the latest relevant literature and clinical experiences from multiple centers. This consensus aims to provide guidance and reference for colleagues.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"15"},"PeriodicalIF":2.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773627","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}