Annals of Gastroenterological Surgery最新文献

{"title":"More Liver Volume Is Necessary for High Risk Living Donor Liver Transplantation Candidates.","authors":"Haruka Kobayashi, Takashi Aida, Kenei Furukawa, Toru Ikegami","doi":"10.1002/ags3.70276","DOIUrl":"10.1002/ags3.70276","url":null,"abstract":"","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Symptom Domains of Postoperative Bowel Dysfunction by Integrating LARS and Wexner Scores: A Longitudinal Factor-Analytic Study.","authors":"Yoshiko Matsumoto, Issei Takeshita, Keiichi Shiokawa, Kurumi Sahara, Taro Munechika, Ken Nagata, Hideki Nagano, Hiroyuki Takahashi, Suguru Hasegawa","doi":"10.1002/ags3.70289","DOIUrl":"10.1002/ags3.70289","url":null,"abstract":"<p><strong>Background: </strong>Postoperative bowel dysfunction after sphincter-preserving surgery for rectal cancer is heterogeneous and may not be fully captured by composite scores such as the low anterior resection syndrome (LARS) and Wexner scores. This study aimed to identify clinically relevant symptom domains and examine their associated clinical factors.</p><p><strong>Methods: </strong>We analyzed 320 patients who underwent low anterior resection with longitudinal bowel function assessment. Correlations among individual LARS and Wexner components were evaluated using Spearman's correlation and hierarchical clustering. Exploratory factor analysis using pooled postoperative observations was performed to identify latent symptom domains, and multivariable mixed-effects models were used to examine associated clinical factors.</p><p><strong>Results: </strong>Correlation analysis demonstrated heterogeneous inter-item relationships, and factor analysis identified three domains: incontinence, urgency/clustering, and gas control. In multivariable analysis, greater incontinence severity was associated with age 50-70 years, BMI ≥ 23, neoadjuvant chemotherapy, radiotherapy, very low anterior resection, and a transanal approach. Greater urgency/clustering severity was associated with radiotherapy, whereas age ≥ 70 years was associated with lower severity. Gas-related symptoms may also represent a partially distinct domain. Postoperative time was a significant determinant of all three domains, with symptom severity remaining higher at 6, 12, and 24 months than preoperatively.</p><p><strong>Conclusions: </strong>Postoperative bowel dysfunction, as captured by the LARS and Wexner scores, appears to consist of multiple symptom domains with different clinical determinants. Patients with similar composite scores may have different symptom profiles requiring different management strategies. A domain-based approach may support individualized functional assessment and treatment after rectal surgery.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Various Hepatic Fibrosis Markers Should Be Evaluated for Causing Complications After Hepatectomy.","authors":"Toru Ikegami, Hiroshi Nakanishi, Kanako Maeda, Kenei Furukawa","doi":"10.1002/ags3.70283","DOIUrl":"10.1002/ags3.70283","url":null,"abstract":"","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Versus Open Surgery for Diverticular Disease: A Structured Review Across Clinical Settings and Operative Strategies.","authors":"Marie Hanaoka, Yudai Fukui, Koya Hida, Hiroya Takeuchi, Yusuke Kinugasa","doi":"10.1002/ags3.70285","DOIUrl":"10.1002/ags3.70285","url":null,"abstract":"<p><p>Laparoscopic surgery is increasingly used to treat colonic diverticulitis; however, its role in emergency, perforated, high-risk, and procedure-specific settings remains uncertain. This structured narrative review evaluated and synthesized comparative evidence by clinical setting, operative strategy, and patient risk profile to provide a clinical decision-making framework for identifying settings in which laparoscopy may offer meaningful benefits and those in which its role remains uncertain. In elective settings, randomized trials and observational studies generally demonstrated short-term advantages of laparoscopy, including reduced postoperative morbidity, less pain, faster recovery, and shorter hospitalization, although clear mid- or long-term superiority has not been established. In emergency, perforated, and high-risk settings, observational and nationwide database studies reported favorable short-term outcomes of laparoscopy; however, these findings were strongly influenced by patient selection, disease severity, and institutional expertise. Benefits were most consistent for resection-based procedures but were less clear for laparoscopic Hartmann procedures and inconsistent for lavage- or drainage-based strategies. Stoma creation rates tended to be lower after laparoscopy in selected cohorts, although this finding depended on disease severity and operative strategy. Evidence regarding intraoperative complications remains limited. Overall, laparoscopic surgery is associated with favorable short-term outcomes, with the most consistent evidence arising from elective diverticular surgery. In emergency surgery and perforated disease, however, the available evidence remains predominantly observational and susceptible to selection bias. These findings support a selective, context-dependent approach based on disease severity, patient condition, operative strategy, and institutional expertise, with careful surgical planning and timely conversion when necessary.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Chemoradiotherapy Expand Immune Checkpoint Blockade Responsiveness in Mismatch Repair-Proficient Rectal Cancer?","authors":"Kimihiro Yamashita, Takeru Matsuda, Junko Mukohyama, Ryohei Sasaki, Yoshihiro Kakeji","doi":"10.1002/ags3.70281","DOIUrl":"https://doi.org/10.1002/ags3.70281","url":null,"abstract":"<p><p>Immune checkpoint blockade (ICB) has transformed the treatment of mismatch repair-deficient (dMMR) colorectal cancer but produces no meaningful benefit in advanced mismatch repair-proficient (pMMR) disease. In the neoadjuvant setting, however, pathological responses have been reported in a subset of pMMR tumors, suggesting that clinical context modifies apparent ICB sensitivity. In pMMR rectal cancer, adding ICB to chemoradiotherapy (CRT) has been associated with pathological complete response (pCR) rates of 30% or more in several trials, higher than expected with CRT alone. These data are clinically provocative, particularly because sustained clinical complete response (cCR) may support watch-and-wait, but pCR and cCR remain early endpoints; long-term disease control and organ-preservation safety remain insufficiently defined. Whether CRT induces ICB responsiveness remains unresolved. The increase in pCR with sequential PD-1 blockade after CRT provides a clinical signal for testing this possibility, but pCR cannot distinguish CRT-induced ICB responsiveness from the simple additive effects of CRT and ICB. Pretreatment T-cell-inflamed features are candidate enrichment markers, but none is validated for patient selection. Priorities are therefore to compare biomarkers associated with ICB responsiveness before and after CRT within the same patients and prospectively validate selection assays. Long-term follow-up must determine whether treatment-induced increases in pCR are accompanied by better disease control and whether organ preservation after sustained cCR is safe.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential Updates in the Surgical Management of Inflammatory Bowel Disease: Current Topics From 2024 to Mid-2026.","authors":"Yoshiki Okita, Tadanobu Shimura, Mikio Kawamura, Yuhki Koike, Yuji Toiyama","doi":"10.1002/ags3.70271","DOIUrl":"https://doi.org/10.1002/ags3.70271","url":null,"abstract":"<p><p>Inflammatory bowel disease management has undergone a major transformation with the introduction of treat-to-target strategies and highly effective biologic and small-molecule therapies. Although these advances have reduced the overall requirement for surgery, operative intervention remains essential for selected patients with ulcerative colitis (UC) and Crohn's disease (CD). Additionally, the role of surgery has evolved considerably, driven by changes in the disease phenotype, advances in minimally invasive techniques, and growing interest in disease-modifying surgical strategies. In UC, colectomy rates have declined, while surgical indications have increasingly shifted toward acute severe colitis, dysplasia, and colorectal cancer. Minimally invasive approaches, including robotic-assisted and transanal techniques, have expanded rapidly and are associated with improved perioperative and functional outcomes. In CD, overall surgical rates have decreased; however, surgery remains indispensable for fibrostenotic, penetrating, and perianal disease. Recent developments include increasing evidence supporting Kono-S anastomosis for reducing postoperative recurrence and ongoing investigation of mesentery-based surgical strategies. Robotic-assisted ileocolic resection has emerged as a safe and feasible minimally invasive option in selected patients. The prevention of postoperative recurrence has evolved toward risk-stratified prophylaxis, early biologic therapy, and treat-to-target monitoring. In perianal CD, multidisciplinary management combining medical and surgical treatment remains the cornerstone of care, while newer biologics and small-molecule therapies continue to expand therapeutic options. This review summarizes the major advances in the surgical management of UC and CD reported between January 2024 and June 2026 and highlights the evolving role of surgery in contemporary multidisciplinary care of inflammatory bowel disease.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Nationwide Volumes for Five Major Gastrointestinal Surgical Procedures in Japan: Implications From Publicly Available NCD and NDB Open Data.","authors":"Atomu Kiriyama, Masakazu Fujii, Toshimichi Asano, Satoshi Hirano","doi":"10.1002/ags3.70282","DOIUrl":"10.1002/ags3.70282","url":null,"abstract":"<p><strong>Aim: </strong>In Japan, the National Clinical Database (NCD), a clinician-reported registry, and the National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data (NDB Open Data), an administrative claims database, are both widely used as nationwide surgical databases, but their consistency in capturing national surgical volumes has not been systematically evaluated.</p><p><strong>Methods: </strong>We compared publicly available data from the NCD annual surgical statistics and the NDB Open Data from 2014 to 2023. Annual case numbers were extracted for five major gastrointestinal procedures: cholecystectomy, inguinal hernia repair, appendectomy, colorectal cancer surgery, and gastric cancer surgery. Consistency was evaluated using three metrics: the median NCD/NDB ratio with interquartile range, Pearson's correlation coefficient for absolute annual volumes, and the proportion of years with concordant year-to-year change.</p><p><strong>Results: </strong>The NCD generally reported higher case volumes than the NDB Open Data, with ratios ranging from close to unity (1.00) for colorectal cancer surgery to 1.10 for appendectomy. Temporal associations between the two databases (Pearson's <i>r</i>) ranged from 0.70 to 0.99 across the five procedures. The proportion of years with concordant year-to-year change ranged from 44% for appendectomy to 100% for colorectal and gastric cancer surgery.</p><p><strong>Conclusion: </strong>Despite relying on clinician-reported data, the NCD demonstrated comparable temporal patterns to the NDB Open Data across the five major gastrointestinal procedures. The stability of procedure-specific NCD/NDB ratios and the concordance of temporal trends support the use of NCD annual statistics for monitoring broad temporal trends in these selected gastrointestinal procedures in Japan.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Surgery Is Associated With Reduced Small Bowel Obstruction Risk After Colorectal Cancer Surgery: A Nationwide Cohort Study of 5458 Patients.","authors":"Takeshi Yamada, Fumihiko Fujita, Ken Eto, Kozo Kataoka, Norio Yukawa, Kiichi Sugimoto, Rai Shimoyama, Atsuko Fukazawa, Kensuke Kumamoto, Yuichi Takayama, Akira Komono, Akihisa Matsuda, Ryo Ohta, Hiromichi Sonoda, Koichi Okuya, Keisuke Ihara, Yasuyuki Yokoyama, Takuya Nishino, Yasuki Akiyama, Daisuke Ichikawa","doi":"10.1002/ags3.70280","DOIUrl":"10.1002/ags3.70280","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative small bowel obstruction (SBO) is a major complication following colorectal cancer surgery, yet evidence-based prevention strategies remain unclear. We aimed to clarify site-specific risk factors for SBO and evaluate the effectiveness of laparoscopic surgery and adhesion prevention materials (APMs) in preventing SBO after colorectal cancer surgery.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 5458 patients who underwent colorectal cancer surgery at 32 Japanese institutions between 2012 and 2014. The primary endpoint was the 5-year risk of SBO. We evaluated the effects of laparoscopic surgery, APM use, and stoma creation on SBO risk. Clinical variables included demographics, tumor site, operative approach, operative details, and postoperative complications. Hospital-level clustering was addressed using mixed-effects logistic regression.</p><p><strong>Results: </strong>Overall SBO incidence was 5.2% (<i>n</i> = 283). Rectal cancer had the highest risk, whereas all colonic sites except the descending colon showed significantly lower odds. Laparoscopic surgery was associated with a 42% reduction in odds (OR 0.58; 95% CI 0.45-0.74; <i>p</i> < 0.001), with significant reductions in ascending (NNT = 22.2, <i>p</i> = 0.001) and sigmoid colon surgery (NNT = 30.2, <i>p</i> = 0.003). APMs showed no protective effect (OR 1.01; 95% CI 0.78-1.32; <i>p</i> = 0.94). Stoma creation significantly increased SBO risk (OR 1.84; 95% CI 1.35-2.51; <i>p</i> < 0.001). Secondary analysis identified reoperation and postoperative ileus as additional independent risk factors.</p><p><strong>Discussion: </strong>Laparoscopic surgery was associated with reduced long-term SBO risk, with significant benefits in ascending and sigmoid colon surgery. APMs showed no measurable benefit. Stoma creation increased SBO risk, with no observed difference between ileostomy and colostomy.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13561679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MicroRNA-941 Acts as a Novel Prognostic Predictor and Oncogenic Driver in Colorectal Cancer.","authors":"Hong Li, Yang Liu, Hua Chen, Jialin Li, Xinchun Li, Yanmin Chen","doi":"10.1002/ags3.70243","DOIUrl":"10.1002/ags3.70243","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to ascertain the expression status, clinical significance, and biological function of microRNA-941 (miR-941) in colorectal cancer (CRC). It elucidates the role of miR-941 in tumor development and the underlying mechanism involving the transcriptional repressor GATA binding 1 (TRPS1).</p><p><strong>Methods: </strong>Serum samples were collected from 150 CRC patients and 150 healthy controls to examine the relative amounts of miR-941. The diagnostic value of miR-941 was evaluated by plotting receiver operating characteristic (ROC) curves. Kaplan-Meier and Cox regression analyses were employed to assess the prognostic implications of miR-941. Functional experiments were conducted in CRC cell lines. The target gene of miR-941 was identified and confirmed through bioinformatics analysis and a dual-luciferase reporter assay.</p><p><strong>Results: </strong>An increased level of miR-941 was found in CRC patients and cell lines (<i>p</i> < 0.001). The preliminary diagnostic performance showed an area under the ROC curve (AUC) of 0.882. Its high expression was tightly in relation to advanced tumor node metastasis stage, lymph node metastasis, and inferior overall survival, serving as an independent prognostic factor (HR = 2.217, <i>p</i> = 0.005). Functionally, inhibition of miR-941 suppressed cellular behaviors and induced changes with ferroptosis phenotypes. Mechanistically, TRPS1 was predicted and verified to be a direct target of miR-941 at both mRNA and protein levels. Moreover, knockdown of TRPS1 could reverse the tumor-suppressive effects and ferroptosis-related changes caused by miR-941 inhibition.</p><p><strong>Conclusion: </strong>Our results identify miR-941 as a novel oncogenic driver in CRC through targeting of TRPS1, serving as a valuable prognostic indicator.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Stoma-Free Outcomes After Diverting Stoma Closure Following Radiation-Based Neoadjuvant Treatment for Rectal Cancer.","authors":"Hidetaka Ichikawa, Shimpei Matsui, Kentaro Sato, Tatsuki Noguchi, Takashi Sakamoto, Toshiki Mukai, Tomohiro Yamaguchi, Takashi Akiyoshi","doi":"10.1002/ags3.70279","DOIUrl":"10.1002/ags3.70279","url":null,"abstract":"<p><strong>Aim: </strong>Long-term stoma-free outcomes after diverting stoma closure in patients who underwent sphincter-preserving rectal cancer surgery with double-stapling technique (DST) reconstruction following radiation-based neoadjuvant treatment remain unclear. We evaluated delayed re-stoma-free survival, causes of delayed re-stoma creation, and final stoma status.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent sphincter-preserving rectal cancer surgery with double-stapling technique reconstruction and diverting stoma creation following radiation-based neoadjuvant treatment between 2011 and 2024. The primary outcome was delayed re-stoma-free survival after initially successful stoma closure. Delayed re-stoma was defined as re-stoma creation more than 30 days after closure.</p><p><strong>Results: </strong>Among 296 patients, 168 received radiotherapy without additional preoperative systemic chemotherapy (non-TNT), and 128 received total neoadjuvant therapy (TNT). Stoma closure was achieved in 287 patients (97.0%). Five required re-stoma creation within 30 days, leaving 282 with initially successful closure. During a median post-closure follow-up of 63 months, delayed re-stoma creation occurred in 25 patients (8.9%): structural anastomotic complications in 14, functional disorders in seven, tumor recurrence in three, and dysmotility-related megacolon in one. Estimated delayed re-stoma-free survival was 93.3% at 3 years and 90.3% at 5 years, with no significant difference between the non-TNT and TNT groups (log-rank <i>p</i> = 0.176). At the last follow-up, 258 patients (87.2%) were stoma-free.</p><p><strong>Conclusion: </strong>Approximately 90% of patients were stoma-free at the final follow-up. Delayed re-stoma creation was most commonly attributable to structural anastomotic complications. Long-term stoma-free status should be considered a clinically meaningful endpoint beyond stoma closure alone.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}