BMC Surgery最新文献

{"title":"Multiple symmetric lipomatosis (Madelung disease) presenting as cervical lipomatous mass in a middle-aged male with alcohol use in Nepal: A Case Report.","authors":"Suzita Hirachan, Adheesh Bhandari","doi":"10.1186/s12893-026-03789-0","DOIUrl":"https://doi.org/10.1186/s12893-026-03789-0","url":null,"abstract":"<p><p>Multiple symmetric lipomatosis (MSL), or Madelung disease, is a rare disorder characterized by symmetrical, non-encapsulated adipose tissue deposition, predominantly involving the neck and upper trunk. It is strongly associated with chronic alcohol consumption.We report a 33-year-old male with a history of regular alcohol intake presenting with a progressively enlarging cervical mass. Imaging revealed bilateral, symmetrical lipomatous deposits consistent with MSL. The patient underwent surgical excision under general anesthesia with satisfactory cosmetic and functional outcomes.This report highlights the clinical presentation, diagnostic approach, and management of MSL, emphasizing the importance of early recognition. A short-term follow-up showed no recurrence; however, long-term surveillance and alcohol cessation remain essential to reduce recurrence risk.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822876","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":"Surgical outcomes of dermabrasion followed by split-thickness skin grafting for post-burn leukoderma: a two-center observational study.","authors":"Abdulkadir Calavul","doi":"10.1186/s12893-026-03756-9","DOIUrl":"https://doi.org/10.1186/s12893-026-03756-9","url":null,"abstract":"<p><strong>Background: </strong>Post-burn leukoderma is a challenging late sequela of deep dermal injury, characterized by persistent hypopigmentation and impaired scar quality. Surgical reconstruction using dermabrasion followed by split-thickness skin grafting (STSG) is commonly employed; however, systematically collected outcome data using validated scar assessment tools for postoperative scar quality evaluation remain limited.</p><p><strong>Methods: </strong>This two-center, observational (ambispective) study included 36 patients with stable post-burn leukoderma who underwent superficial dermabrasion followed by STSG at Afrin State Hospital and Şanlıurfa Metrolife Hospital. Perioperative clinical data from procedures performed between May 2020 and July 2024 were collected retrospectively. Following ethics approval in May 2025, prospective scar evaluations were conducted between May and July 2025 using the Patient and Observer Scar Assessment Scale (POSAS). Associations between POSAS scores and demographic or clinical variables were analyzed using non-parametric statistical methods.</p><p><strong>Results: </strong>Patient- and observer-rated POSAS scores demonstrated a very strong correlation (ρ = 0.924, p < .001), indicating excellent concordance between patient-reported and clinician-assessed scar quality. Age, sex, and burn size showed no significant associations with POSAS outcomes (all p > .05). In contrast, postoperative complications were strongly associated with significantly higher (worse) POSAS scores in both patient and observer assessments (p < .001), with large effect sizes (r ≥ .68).</p><p><strong>Conclusions: </strong>Dermabrasion followed by STSG was associated with acceptable postoperative scar outcomes in patients with stable post-burn leukoderma, with strong agreement between patient and clinician evaluations of scar quality. The findings highlight complication-free healing as a key determinant of more favorable scar outcomes. Because POSAS evaluates scar quality rather than pigmentation directly, further controlled studies incorporating objective pigment-specific or colorimetric assessments are warranted to better define treatment-related repigmentation outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822908","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":"Serous cystadenoma of the pancreatic head associated with pancreatic duct atresia and acinar cell loss: a case report.","authors":"Ting-Yu Yang, Ming-Dong Chen, Ai-Ping Huang, Qian-Jun Yu, Zhi Zhong, Chuan Zhao, Chun-Lin Deng, Long Cheng","doi":"10.1186/s12893-026-03772-9","DOIUrl":"https://doi.org/10.1186/s12893-026-03772-9","url":null,"abstract":"<p><strong>Background: </strong>Serous cystadenoma (SCA) of the pancreas is typically a benign neoplasm, and variants are exceptionally rare. While tumors in the pancreatic head often cause upstream ductal dilatation and parenchymal atrophy due to obstruction, the concurrent presentation of SCA with congenital distal pancreatic duct atresia and complete acinar cell loss is unique. We report this case to highlight a potential congenital pathogenesis linking ductal developmental defects to the formation of these lesions.</p><p><strong>Case presentation: </strong>A 56-year-old woman presented with persistent right upper abdominal distension and discomfort lasting over one year. She had a 20-year history of an abdominal mass and had undergone two previous unsuccessful surgical interventions, including a palliative bypass and an aborted resection. Preoperative imaging revealed a large cystic-solid mass in the pancreatic head. Intraoperative exploration identified a 12-cm lesion replacing the pancreatic head and neck, accompanied by complete fatty replacement of the pancreatic body and tail. The patient underwent en bloc pancreaticoduodenectomy with partial portal vein resection and synthetic vascular graft reconstruction. Histopathological examination confirmed the diagnosis of SCA. Notably, the distal pancreatic tissue exhibited a complete absence of acini and visible ductal structures, while islet cells were preserved. Postoperative recovery was uneventful, and at the 12-month follow-up, the patient remained disease-free with preserved endocrine function despite the loss of exocrine function.</p><p><strong>Conclusions: </strong>This case illustrates the rare coexistence of a SCA with congenital distal pancreatic duct atresia and acinar cell depletion. The preservation of islet function amidst complete exocrine loss supports a developmental anomaly rather than obstruction-induced atrophy. This association suggests that congenital ductal defects may predispose patients to SCA formation. Surgical resection remains the optimal strategy for the diagnosis and management of atypical cystic pancreatic lesions with uncertain biological behavior.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822838","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":"Optimization of surgical strategies and clinical efficacy analysis for infected classic preauricular fistula.","authors":"Xufeng Pan, Xianghang Lin, Yuting Huo, Yunliang Liu","doi":"10.1186/s12893-026-03794-3","DOIUrl":"https://doi.org/10.1186/s12893-026-03794-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated the effects of surgical timing, microscope-assisted operation, and partial helix crus cartilage resection on operation duration, postoperative incision healing, recurrence rate, and scar formation in children with infected classic preauricular fistula, analyzed the clinical value of different surgical strategies for its standardized treatment, and ensured result reliability via rigorous control of selection and temporal confounding.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was performed on 74 children who underwent surgery for infected classic preauricular fistula, grouped by intraoperative infection status (early erythema-swelling, prolonged erythema-swelling, localized abscess), microscope application, and cartilage resection. Selection bias was controlled by baseline comparison; confounders (age, sex, infection severity) were adjusted via 1:1 propensity score matching (PSM) and multivariable regression. Group differences in key efficacy indicators were compared, with nonparametric tests for non-normally distributed data (median [IQR]). Post-hoc power analysis and learning curve analysis (study period: 2021-2023 [early], 2024-2025 [late]) were also conducted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline characteristics were comparable across all groups (P &gt; 0.05). For surgical timing subgroups, recurrence rate and incision healing showed no intergroup differences (P &gt; 0.05), but the localized abscess group had significantly longer operation duration (61.8 ± 8.8 min, median 62.0 [56.0-68.0] min) and lower scar scores (2.5 ± 0.6 points, median 2.0 [2.0-3.0] points) than the early (37.7 ± 4.9 min, median 38.0 [35.0-41.0] min) and prolonged erythema-swelling groups (42.7 ± 7.4 min, median 43.0 [38.0-47.0] min) (P &lt; 0.05), with no significant difference in median [IQR] follow-up time (P &gt; 0.05). Microscope application had no significant effects on all efficacy indicators (P &gt; 0.05), with consistent results after PSM; follow-up time and recurrence rate also showed no intergroup differences (P &gt; 0.05). The cartilage resection group had a significantly lower postoperative recurrence rate (1.75%, 1/57) than the non-resection group (17.65%, 3/17), with this difference remaining significant after multivariable regression (P &lt; 0.05). Learning curve analysis revealed significantly shorter operation duration in the late study stage (59.2 ± 10.8 min) than the early stage (68.5 ± 12.3 min, P &lt; 0.001), with no difference in recurrence rate (4.8% vs. 1.7%, P = 0.321). Post-hoc power analysis showed 72% power for detecting recurrence rate differences and 89% for operation duration differences. Subgroup analyses found no significant recurrence rate differences between non-abscess and abscess groups (2.0% vs. 4.5%, P = 0.432) or between different preoperative management groups (2.6% vs. 4.5%, P = 0.587).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;For children with infected classic preauricular fistula, early i","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822897","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":"Robotic versus conventional nipple-sparing mastectomy in early breast cancer: a systematic review and meta-analysis.","authors":"Zhiyao Wang, Huiming Wu, Feiyu Chen, Minjie Hou, Zhi Li","doi":"10.1186/s12893-026-03799-y","DOIUrl":"https://doi.org/10.1186/s12893-026-03799-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to systematically compare robot-assisted nipple-sparing mastectomy (R-NSM) with conventional nipple-sparing mastectomy (C-NSM) in terms of perioperative safety and oncological outcomes through a meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive literature search was conducted in PubMed/MEDLINE, Web of Science Core Collection, Embase, and the Cochrane Central Register of Controlled Trials from database inception to February 27, 2026. Controlled studies comparing robotic nipple-sparing mastectomy (R-NSM) and conventional nipple-sparing mastectomy (C-NSM) in women with early-stage breast cancer (stage 0-II, including a small proportion of risk-reducing mastectomy cases) were included. Study selection and data extraction were independently performed by two reviewers, with discrepancies resolved by consensus. Statistical analyses were conducted using Review Manager (RevMan) version 5.4. The primary outcomes were overall postoperative complications, major complications (Clavien-Dindo grade ≥ III), positive surgical margin, and local recurrence. Secondary outcomes included operative time, estimated intraoperative blood loss, length of hospital stay, reoperation rate, and individual postoperative complications (including nipple-areolar complex necrosis, skin-flap necrosis, surgical-site infection, hematoma, seroma, delayed wound healing, and implant loss). Perioperative mortality was not reported in the included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 12 studies involving 2,312 patients (1 RCT and 11 non-randomized studies) were included in the quantitative synthesis. The reported follow-up duration across included studies ranged from 3 to approximately 51 months, with most studies reporting a median or mean follow-up of around 18-30 months. Compared with C-NSM, R-NSM was associated with a lower incidence of overall postoperative complications (RR = 0.82, 95% CI: 0.68-0.99, P = 0.04) and major complications defined as Clavien-Dindo grade ≥ III (RR = 0.44, 95% CI: 0.22-0.86, P = 0.02). R-NSM was also associated with a reduced risk of delayed wound healing (RR = 0.51, 95% CI: 0.26-0.98, P = 0.04). However, no statistically significant differences were observed between the two approaches with respect to nipple-areolar complex necrosis, skin flap necrosis, postoperative infection, hematoma, seroma, implant loss, reoperation rate, positive surgical margin, or local recurrence. R-NSM was associated with longer operative time and a modest reduction in intraoperative blood loss. However, TSA suggested that the cumulative evidence remains insufficient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Current evidence suggests that, under strict patient selection, R-NSM does not appear to compromise short-term perioperative safety or oncological outcomes when compared with the conventional approach. Although a reduction in composite postoperative complications was observed, no significant differences were ","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822905","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 rare case of colorectal duplication with rectourethral fistula in a child: diagnostic challenges and surgical management from Northwest Ethiopia.","authors":"Nebiyu Shitaye","doi":"10.1186/s12893-026-03804-4","DOIUrl":"https://doi.org/10.1186/s12893-026-03804-4","url":null,"abstract":"<p><strong>Background: </strong>Alimentary tract duplications are rare congenital anomalies. Colorectal duplication is particularly uncommon and may present with nonspecific features, posing diagnostic challenges. An association with rectourethral fistula is extremely rare.</p><p><strong>Case presentation: </strong>A 2-year-old male child presented with chronic constipation, abdominal distension, failure to thrive, and recurrent urinary tract infections. The later development of pneumaturia and fecaluria suggested an enterourinary fistula. Contrast enema demonstrated a reversed rectosigmoid ratio without a clear transition zone, initially raising suspicion for Hirschsprung disease. Voiding cystourethrography confirmed a rectourethral fistula. Surgical exploration revealed a duplicated sigmoid colon and rectum. Due to diagnostic uncertainty and poor nutritional condition of the child, a staged surgical approach was undertaken. Initial surgery involved diverting sigmoid colostomy and rectal biopsy. Histopathology excluded Hirschsprung disease. Definitive surgery included excision of the duplicated colorectal segment, pull-through reconstruction, and fistula repair. The postoperative course was uneventful with marked improvement in nutritional status and bowel function.</p><p><strong>Conclusion: </strong>Colorectal duplication with rectourethral fistula is a rare condition that may present with overlapping features of other colorectal disorders. Careful clinical evaluation, appropriate imaging, and staged surgical management are essential for optimal outcomes, particularly in resource-limited settings.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822894","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 bellwether surgical outcomes in Ethiopia: insights from a multicentre 7-day prospective cohort study.","authors":"Atalel Fentahun Awedew","doi":"10.1186/s12893-026-03790-7","DOIUrl":"https://doi.org/10.1186/s12893-026-03790-7","url":null,"abstract":"<p><strong>Introduction: </strong>Bellwether procedures-emergency laparotomy, caesarean section, and open fracture management-are among the most cost-effective interventions for addressing diverse emergency surgical conditions. However, inequitable access and high postoperative complication rates remain major challenges, particularly in low- and middle-income countries. This study aims to provide robust epidemiological data on postoperative outcomes following bellwether surgeries in Ethiopia.</p><p><strong>Method: </strong>We conducted a 7-day, multicentre, national, prospective observational cohort study of adult patients undergoing bellwether surgical procedures in Ethiopia. Hospitals were recruited through convenience sampling across all twelve administrative regions. The primary outcomes were postoperative complications and mortality occurring within 7 days of surgery. We performed descriptive analyses to summarize patient demographics, perioperative characteristics, and outcome frequencies. To identify independent risk factors for postoperative complications, we applied multivariable logistic regression models, reporting adjusted odds ratios with 95% confidence intervals.</p><p><strong>Results: </strong>Among 4412 surgical patients across 46 Ethiopian hospitals, 2181 procedures (49.4%) were classified as bellwether surgeries. The median age was 27 years (IQR ± 8), and most patients were ASA IIE (53.8%, 1174/2181) and ASA IE (41.2%,899/2181). The majority of procedures were of intermediate complexity (70.7%), and 77.3% were emergencies. Caesarean section was the most common bellwether procedure (61.9%), followed by emergency laparotomy (23.6%). At 7 days postoperatively, the overall complication rate was 18.7%, with 8 deaths (0.4%). After adjustment for confounders, smoking (AOR 2.5, 95% CI 1.9-3.4), comorbidity (AOR 2.8, 95% CI 2.1-3.9), and major surgery (AOR 2.4, 95% CI 1.2-4.9) were independently associated with postoperative complications.</p><p><strong>Conclusion: </strong>Approximately one in five patients in Ethiopia experienced postoperative complications following bellwether surgery, despite being predominantly young, low-risk, and undergoing procedures of intermediate severity. Strengthening evidence-based interventions, improving perioperative processes, and reinforcing the foundations of the surgical system are essential to achieve safe, effective, and equitable surgical outcomes nationwide.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787067","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":"Passage of a percutaneous endoscopic gastrostomy tube through the liver: a case report and review of the literature.","authors":"Jun Zhou, Dexian Wang","doi":"10.1186/s12893-026-03796-1","DOIUrl":"https://doi.org/10.1186/s12893-026-03796-1","url":null,"abstract":"<p><strong>Background: </strong>Passage of a percutaneous endoscopic gastrostomy (PEG) tube through the liver during PEG is a rare but potentially serious complication.</p><p><strong>Case presentation: </strong>Here, we report the case of a 78-year-old male patient with dysphagia who underwent PEG in our hospital. Follow-up abdominal computed tomography (CT) revealed that the PEG tube had passed through the left lobe of the liver. This situation poses a clinical dilemma as to whether to remove the tube or allow it to remain in place. Based on existing literature, transhepatic PEG tubes can be used for long periods of time. In our case, the sinus tract was immature and there were no immediate concerns with regards to serious complications. Therefore, we decided to retain the PEG tube and observe the patient, incorporating tube care, regular disinfection, and dressing changes. The patient has been using his PEG tube for over five years with no severe complications. To the best of our knowledge, this is the longest PEG tube has been allowed to remain in place.</p><p><strong>Conclusions: </strong>The transhepatic insertion of a PEG tube is an extremely rare complication of PEG. Our experience indicates that a PEG tube can be retained and used for a long period of time in the absence of serious complications related to a transhepatic PEG tube. Caregivers should pay particular attention to the disinfection and daily management of PEG tubes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822900","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 use of hooks in upper instrumented vertebra to prevent proximal junctional complications: a systematic review and meta-analysis.","authors":"Hifza Babar, Dong Li, Jie Li, Zhen Liu, Zezhang Zhu, Yong Qiu","doi":"10.1186/s12893-026-03757-8","DOIUrl":"https://doi.org/10.1186/s12893-026-03757-8","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822840","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":"Hartmann's procedure reversal rate and short-term outcomes: a single centre retrospective cohort study.","authors":"Christopher C L Liao, Balakrisanan Saravanan, Fatima Ismail, Matthew Farmer, Vamsi R Velchuru","doi":"10.1186/s12893-026-03738-x","DOIUrl":"https://doi.org/10.1186/s12893-026-03738-x","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822864","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}