Techniques in Coloproctology最新文献

{"title":"Impact of sentinel pile on botulinum toxin treatment of chronic anal fissure: A comparative study.","authors":"Javid Ahmadov, Mustafa Anıl Turhan, Ender Ergüder, Sezai Leventoglu, Bülent Mentes","doi":"10.1007/s10151-026-03309-5","DOIUrl":"https://doi.org/10.1007/s10151-026-03309-5","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to investigate if the presence of a prominent sentinel pile (SP) had any impact on the treatment success of botulinum toxin (BT) injection, as well as the clinical presentation of patients with chronic anal fissure (CAF).</p><p><strong>Methods: </strong>Patients with CAF with or without prominent sentinel piles underwent BT injection. In addition to objective healing, a detailed symptom severity score (REALISE) immediately before and 6 months after BT injection was recorded. This was a retrospective, single-center observational cohort study including consecutive patients treated in a specialized proctology unit.</p><p><strong>Results: </strong>Of the 249 patients, 68 presented with prominent SP (27.3%). The overall objective healing rate among all patients who received a single injection of BT was found to be 74.7% at 2 months. When stratified, age distribution was similar between patients with (SP+) and without SP (SP-) (p = 0.545). However, SP was more prevalent in female patients (p = 0.009). The objective healing rates after a single BT injection were 80.7% in the SP- group and 58.8% in the SP+ group (p = 0.001). Pre-treatment REALISE scores were significantly reduced in both groups after BT injection (p < 0.001 for both). However, post-treatment scores were higher in the SP+ group compared with the SP- group (p < 0.001). Multivariable analysis confirmed SP presence as an independent predictor of reduced objective healing after BT injection.</p><p><strong>Conclusions: </strong>Even with the SP, a considerable proportion of patients with CAF heal after BT treatment and their symptoms are generally relieved. However, symptomatic improvement is less marked and the objective healing rates are lower in the SP+ group. The presence of SP may, therefore, negatively influence the clinical effectiveness of BT treatment of CAF. These findings should be interpreted in light of the retrospective single-center design and the potential for selection and recall bias.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823251","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":"Docking optimization for right hemicolectomy with complete mesocolon excision (CME) with HUGO™ robotic system: the \"Gemelli configuration\".","authors":"Claudio Fiorillo, Davide De Sio, Beatrice Biffoni, Flavia Taglioni, Roberta Menghi, Antonio Pio Tortorelli, Sergio Alfieri, Giuseppe Quero","doi":"10.1007/s10151-026-03316-6","DOIUrl":"https://doi.org/10.1007/s10151-026-03316-6","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic complete mesocolic excision (CME) during right hemicolectomy is a complex procedure. The introduction of robotic-assisted surgery has improved dexterity, three-dimensional (3D) visualization, and surgeon ergonomics. However, for the modular HUGO™ Robotic-Assisted Surgery (RAS) system, experience with CME is limited, and the standard docking configuration for right hemicolectomy presents many disadvantages.</p><p><strong>Methods: </strong>We developed a modified docking strategy (the \"Gemelli configuration\") specifically designed to optimize robotic right hemicolectomy with CME using the HUGO™ RAS platform. This setup provides improved instruments triangulation and reduced robotic arm interference. The technique was applied in two consecutive cases.</p><p><strong>Results: </strong>Both procedures were completed fully robotically with a single docking, without arm collisions or the need for repositioning. Compared with the standard setup, the Gemelli configuration yields enhanced visualization of the mesenteric axis and vascular pedicles and improved access to the transverse mesocolon.</p><p><strong>Conclusions: </strong>The \"Gemelli configuration\" represents a safe, simple, and reproducible docking strategy for performing right hemicolectomy with CME using the HUGO™ RAS system. Further validation in larger patient series is warranted to confirm these preliminary benefits.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823270","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":"Evaluation of autologous fat injection as a minimally invasive technique for rectocele repair: a prospective pilot study.","authors":"I A Shafik, M M Abdelfatah, A Shafik, E Hagagy, M Ali","doi":"10.1007/s10151-026-03322-8","DOIUrl":"https://doi.org/10.1007/s10151-026-03322-8","url":null,"abstract":"<p><strong>Background: </strong>Rectocele repair remains challenging owing to high recurrence and morbidity associated with traditional surgical techniques. Autologous fat injection has emerged as a biologically integrative method that strengthens native pelvic tissues through regenerative mechanisms. This prospective pilot study evaluated feasibility, safety, and short-term anatomical and functional outcomes of autologous fat injection for rectocele repair.</p><p><strong>Methods: </strong>Between October 2023 and June 2025, 25 women with symptomatic Baden-Walker grade II-III rectocele and obstructed defecation syndrome (ODS) were prospectively enrolled at Kasr Al-Ainy Hospital, Cairo University. Abdominal fat was harvested, mechanically emulsified, and injected into the rectovaginal septum using a 15-gauge blunt cannula (mean injected volume 52 ± 10 mL). Outcomes included rectocele size on magnetic resonance (MR) defecography, clinical Baden-Walker grade, predefined ODS symptom categories/defecation frequency, and complications.</p><p><strong>Results: </strong>Mean rectocele size decreased from 3.28 ± 0.82 to 1.82 ± 0.47 cm (p < 0.001). Overall, 80% of patients reported complete symptomatic improvement, while 20% reported recurrent symptoms during follow-up. Transient postoperative constipation occurred in 20% of patients and resolved conservatively. No major complications occurred. Injected volume showed an exploratory association with anatomical improvement.</p><p><strong>Conclusions: </strong>Autologous fat injection for rectocele repair appears feasible and safe, with a signal of short-term anatomical and functional improvement in this pilot cohort. Larger comparative studies using validated patient-reported outcomes and standardized imaging follow-up are required.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"30 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823283","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":"Short- and mid-term outcomes of transanal/transperineal minimally invasive surgery for locally recurrent rectal cancer.","authors":"Y Tsukada, S Sasaki, T Mori, M Wakabayashi, T Ikeno, K Ikeda, H Hasegawa, Y Nishizawa, M Ito","doi":"10.1007/s10151-026-03312-w","DOIUrl":"https://doi.org/10.1007/s10151-026-03312-w","url":null,"abstract":"<p><strong>Background: </strong>Surgical resection, the primary treatment for locally recurrent rectal cancer (LRRC), is technically challenging. Transanal/transperineal minimally invasive surgery (Ta/Tp MIS) improves visualization and access through undisturbed planes. This study compared the short- and mid-term outcomes of Ta/Tp MIS with those of conventional non-Ta/Tp MIS for LRRC.</p><p><strong>Methods: </strong>This retrospective observational study involved 98 patients who underwent curative-intent surgery for LRRC at a single tertiary cancer center between April 2008 and March 2022. Patients were classified into Ta/Tp MIS (n = 34) and non-Ta/Tp MIS (n = 64) groups. Perioperative and mid-term oncologic outcomes were compared, including operative time, blood loss, intraoperative transfusion, postoperative complications, pathological R0 resection, recurrence-free survival, local recurrence, and overall survival.</p><p><strong>Results: </strong>Ta/Tp MIS was associated with reductions in resection time (median, 225 versus 252 min; p = 0.0176), blood loss (median, 420.5 versus 1068 mL; p < 0.0001), and intraoperative transfusions (17.7% versus 48.4%, p = 0.0041), and tended toward a shorter operative time (median, 366.5 versus 418.5 min; p = 0.1170). R0 resection (91.2% versus 89.1%), postoperative complications (overall Clavien-Dindo complication grade: 76.5% versus 75.0%, p = 1; grade ≥ 3: 41.2% versus 37.5%, p = 0.8282), 3-year recurrence-free survival (46.3% versus 44.2%, p = 0.9079), local recurrence (24.8% versus 37.7%, p = 0.3130), and 3-year overall survival (89.7% versus 77.7%, p = 0.2271) were comparable between groups.</p><p><strong>Conclusions: </strong>Ta/Tp MIS appears to be a feasible surgical approach for selected patients with LRRC, and in this retrospective analysis, was associated with shorter resection time and reduced blood loss. No clear differences were observed in postoperative complications or short- to mid-term oncologic outcomes compared with conventional approaches.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823278","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":"Correction: Deep remission improves the quality of life of patients with Crohn's disease and anoperineal fistula treated with darvadstrocel: results of a French pilot study.","authors":"N Fathallah, M Akaffou, M A Haouari, L Spindler, A Alam, A Barré, E Pommaret, A Fels, V de Parades","doi":"10.1007/s10151-026-03327-3","DOIUrl":"10.1007/s10151-026-03327-3","url":null,"abstract":"","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"30 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788387","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":"Technique and results of novel intracorporeal \"overlap\" colorectal anastomosis for laparoscopic and robotic surgery.","authors":"A V Sazhin, I V Ermakov, G B Ivakhov, I S Lebedev, K D Dalgatov, M V Poltoratsky, I S Shikhin, N A Timoshenko, I A Morozov","doi":"10.1007/s10151-026-03308-6","DOIUrl":"https://doi.org/10.1007/s10151-026-03308-6","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic colorectal procedures are widely adopted for colorectal cancer surgery. The double-stapling technique for circular colorectal anastomosis carries leakage rates of 11.2-13.4% and elevates stricture risk. In 2024, we introduced an innovative intracorporeal linear isoperistaltic \"overlap\" colorectal anastomosis; preliminary data from ten patients confirmed its safety and feasibility. This study aims to assess the feasibility and safety of the colorectal \"overlap\" anastomosis technique for laparoscopic and robotic surgery on a larger group of patients.</p><p><strong>Methods: </strong>An observational study was conducted from 2023 to 2025. A total of 100 patients with adenocarcinoma of the distal sigmoid colon, rectosigmoid junction, or upper rectum underwent laparoscopic or robotic colorectal surgery with intracorporeal \"overlap\" colorectal anastomosis. Demographic, intraoperative, and postoperative data, including complications, length of hospital stay, and 30-day readmission rates, were analyzed. Colonoscopy at 6 months assessed anastomosis configuration and patency.</p><p><strong>Results: </strong>The intracorporeal linear \"overlap\" colorectal anastomosis was performed in 100 patients (51 laparoscopic, 49 robotic-da Vinci Xi). Mean age was 67.0 ± 10.1 years and median body mass index (BMI) 26.9 kg/m² (interquartile range [IQR]: 24.4-30.4); 76 patients were classified as American Society of Anesthesiologists (ASA) II and 24 were ASA III. Per pTNM staging, 33 patients had stage I, 27 stage II, 38 stage III, and 2 stage IV. Median blood loss was 30.0 mL (20-50), operative time 240.0 min (210.0-282.5), lymph nodes harvested 13 (11-18), and time to bowel function recovery 48 h (24-48). No intraoperative complications, conversions, or technical deviations, anastomotic leaks, major complications (Clavien-Dindo grades ≥ III), strictures, or 30-day readmissions occurred. Median postoperative stay was 5 days (4-6).</p><p><strong>Conclusions: </strong>The novel intracorporeal linear \"overlap\" colorectal anastomosis is safe and feasible and may be recommended as a reliable alternative to the conventional circular anastomosis in both laparoscopic and robotic colorectal surgery.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788374","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":"Milligan-Morgan hemorrhoidectomy, mucopexy, and hybrid combination for grade III hemorrhoids: a large retrospective cohort study.","authors":"Gaetano Gallo, Veronica De Simone, Gianpiero Gravante, Salvatore Sorrenti, Simone Tierno, Federico Tomassini, Antonio Crucitti, Pierpaolo Sileri, Marco La Torre","doi":"10.1007/s10151-026-03291-y","DOIUrl":"https://doi.org/10.1007/s10151-026-03291-y","url":null,"abstract":"<p><strong>Background: </strong>Mucopexy has emerged as a nonexcisional alternative to Milligan-Morgan (MM) hemorrhoidectomy.</p><p><strong>Objective: </strong>This study compares MM, mucopexy, and hybrid MM/mucopexy procedures in patients with grade III hemorrhoidal disease (HD).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral setting.</p><p><strong>Patients: </strong>Symptomatic grade III HD treated between 2016 and 2018.</p><p><strong>Interventions: </strong>Four groups were defined: group 1 included patients treated with MM alone; group 2 received mucopexy on one pile combined with MM on the remaining two; group 3 underwent mucopexy on two piles with MM on the remaining one; and group 4 was treated with mucopexy alone.</p><p><strong>Main outcomes measures: </strong>Recurrence rates and patient-reported outcome measures (PROMs) using a visual-analogic scale (VAS) at 2 years, postoperative pain at 7 days, early complication rates at 30 days, and PROMs at 30 days.</p><p><strong>Results: </strong>A total of 686 consecutive patients with III-degree HD were included in the analysis. The most frequent approach was MM alone (group 1, n = 309, 45%), followed by mucopexy alone (group 4, n = 138, 20.2%), then the combined approaches (group 2, n = 120, 17.5%; group 3, n = 119, 17.3%). Group 4 had the lowest pain scores and the highest 30-day PROM (p < 0.001), whereas group 1 showed the best long-term results, with the lowest recurrence rate (4.2% versus 14.5% in group 4) and highest long-term PROM.</p><p><strong>Limitations: </strong>Retrospective analysis.</p><p><strong>Conclusions: </strong>Mucopexy and the hybrid procedures reduce morbidity and enhances early postoperative PROM in grade III HD. However, its higher recurrence rate suggests that a patient- and pile-specific approach may help balance efficacy with surgical invasiveness.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788382","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":"Rethinking risk in Crohn's surgery: age at onset fails to predict surgical outcomes after ileocecal resection, insights from a tertiary referral center.","authors":"T Violante, S Cardelli, F Flamini, G Calini, M Novelli, M Rottoli","doi":"10.1007/s10151-026-03304-w","DOIUrl":"https://doi.org/10.1007/s10151-026-03304-w","url":null,"abstract":"<p><strong>Background: </strong>Early age at diagnosis in Crohn's disease is linked to aggressive phenotypes, yet evidence regarding its impact on surgical risk remains inconsistent. This study aimed to elucidate the relationship between age at diagnosis, utilizing Vienna and Montreal classifications, and surgical prognosis in patients undergoing ileocecal resection.</p><p><strong>Methods: </strong>A retrospective analysis of a prospective database identified 810 patients undergoing ileocecal resection between 2014 and 2022. Patients were stratified by Vienna (< 40 versus > 40 years) and Montreal (A1, A2, A3) classifications. Primary end points included 30-day overall complications, serious complications, reoperation and readmission. Statistical analysis employed multivariable regression, propensity score matching, G-computation and Random Forest models to adjust for confounders.</p><p><strong>Results: </strong>Baseline characteristics differed significantly: younger patients exhibited more penetrating disease and biologic exposure, while older patients had higher ASA scores and comorbidities. After robust adjustment, the Vienna and Montreal age classification showed no significant association with postoperative complications, serious complications, reoperation or readmission. Random Forest analysis consistently identified ASA score and comorbidities, rather than age at onset, as the dominant predictors of surgical outcomes.</p><p><strong>Conclusions: </strong>Age at diagnosis does not independently predict short-term surgical outcomes after ileocecal resection. Postoperative morbidity is driven primarily by general health markers, such as ASA score, rather than disease onset timing. These findings highlight the need for validated disease-specific risk scores.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788450","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":"Video vignette: robotic ileocolic resection for Crohn's disease with enterocutaneous fistula takedown.","authors":"I S Alam, Y Bornstein, J Simon, M Grieco, C Atallah, B Safar, I Le Leannec, A da Luz Moreira","doi":"10.1007/s10151-025-03284-3","DOIUrl":"https://doi.org/10.1007/s10151-025-03284-3","url":null,"abstract":"","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718837","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":"First worldwide comparison of right hemicolectomy for colon cancer using vaginal natural orifice transluminal endoscopic surgery (VNOTES) versus transvaginal natural orifice specimen extraction surgery (TVNOSE).","authors":"I Seow-En, M Y M Chee, S W-Y Liu, Y W Y Wong, J X Ang","doi":"10.1007/s10151-026-03287-8","DOIUrl":"https://doi.org/10.1007/s10151-026-03287-8","url":null,"abstract":"<p><strong>Background: </strong>In colorectal transvaginal natural orifice specimen extraction (TVNOSE) surgery, the specimen is retrieved via the vagina instead of conventional transabdominal removal. Vaginal natural orifice transluminal endoscopic surgery (VNOTES) uses transvaginal access for bowel mobilisation, oncologic resection, anastomotic creation, followed by TVNOSE. We aimed to compare VNOTES versus TVNOSE for right hemicolectomy.</p><p><strong>Methods: </strong>From April 2023 to February 2025, our initial five consecutive VNOTES right hemicolectomy procedures were compared against five consecutive TVNOSE right hemicolectomies. Inclusion criteria for both procedures were elective non-metastatic right-sided colon adenocarcinoma resection with maximum tumour diameter < 6.0 cm. There were no differences in patient or tumour selection criteria between the TVNOSE and VNOTES procedures.</p><p><strong>Results: </strong>All patients underwent D3 lymphadenectomy with fully stapled antiperistaltic ileocolic anastomosis. No cases required conversion to open surgery or transabdominal specimen extraction. VNOTES had a longer median operative time by 105 min. The cumulative length of all abdominal wounds was significantly longer in the TVNOSE group compared to the VNOTES group at 27 mm vs. 10 mm, P = 0.012. There was a trend towards reduced postoperative day 1 and 2 pain scores, as well as quicker time to gastrointestinal recovery following VNOTES. Maximum tumour diameter, total lymph node harvest, and distribution of pathological T and N stages were comparable between both groups. There was one instance of postoperative ileus following TVNOSE surgery.</p><p><strong>Conclusion: </strong>This first worldwide comparison of VNOTES versus TVNOSE right hemicolectomy demonstrates comparable safety and short-term outcomes, with reduced abdominal wounds and potential benefits in early recovery following VNOTES.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718823","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}