Annals of Coloproctology最新文献

{"title":"Effect of oral antibiotic bowel preparation versus no preparation on surgical site infections in elective colorectal surgery: a randomized trial.","authors":"Kavyashree Mallesh, Rajendran Theakarajan, Balasubramanian G, Prashant Penumadu, Raja Kalayarasan, Rajkumar Nagarajan","doi":"10.3393/ac.2025.00633.0090","DOIUrl":"10.3393/ac.2025.00633.0090","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical site infections (SSIs) represent a significant cause of morbidity following colorectal surgery. While mechanical bowel preparation combined with oral antibiotics is known to reduce SSIs, the independent effect of oral antibiotics alone remains unclear. This study compared the efficacy of oral antibiotic bowel preparation (OABP) versus no bowel preparation (NBP) in reducing SSIs among patients undergoing elective colorectal surgery.</p><p><strong>Methods: </strong>A prospective, randomized, double-blinded trial was performed at a tertiary care center in India. Eighty-six patients scheduled for elective colorectal surgery were randomized to receive either OABP (oral ciprofloxacin and metronidazole) or placebo, in addition to standard intravenous antibiotics. The primary outcome was the rate of SSIs. Secondary outcomes included anastomotic leak, length of hospital stay, overall morbidity, and readmission rates.</p><p><strong>Results: </strong>Baseline characteristics were comparable between the groups. The incidence of SSI was significantly lower in the OABP group compared to the NBP group (14.0% vs. 41.9%, P<0.01). The severity of infections and postoperative complications was also reduced in the OABP group (P<0.01). Although rates of anastomotic leak, readmission, and reoperation were higher in the NBP group, these differences were not statistically significant. The mean duration of hospital stay was shorter for patients in the OABP group (8.09 days vs. 11.28 days, P<0.01). No adverse effects related to oral antibiotics were observed.</p><p><strong>Conclusion: </strong>OABP without mechanical cleansing significantly reduces SSIs, postoperative morbidity, and length of hospital stay in elective colorectal surgery. This approach is safe and effective, offering a strategy to improve surgical outcomes.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 5","pages":"393-399"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145386313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular vesicles in colorectal cancer.","authors":"Young Il Kim, Chungyeop Lee, Hakho Lee, In Ja Park","doi":"10.3393/ac.2025.00745.0106","DOIUrl":"10.3393/ac.2025.00745.0106","url":null,"abstract":"<p><p>Colorectal cancer (CRC) remains a major global health issue, with challenges including early detection and recurrence monitoring. While colonoscopy and fecal-based tests are standard screening tools, their limitations have driven interest in less invasive alternatives. Extracellular vesicles (EVs) present in patient liquid biopsy samples have emerged as potential biomarkers and therapeutic tools in CRC. EVs carry molecular cargo, including nucleic acids and proteins, that reflect the status of their cells of origin and can be readily accessed through minimally invasive liquid biopsy. This review outlines the role of EVs in the initiation and progression of CRC, summarizes recent advances in EV isolation techniques, and highlights candidate EV-derived biomarkers for diagnosis, prognosis, and treatment monitoring. By providing an updated synthesis of current research, this review aims to inform future studies and support clinical translation of EV-based approaches in CRC.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 5","pages":"379-392"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145386325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of intramural rectal botulinum toxin injections for urge fecal incontinence: a salvage therapy for sacral neuromodulation nonresponders?","authors":"Philippe Onana Ndong, Véronique Vitton","doi":"10.3393/ac.2025.00332.0047","DOIUrl":"10.3393/ac.2025.00332.0047","url":null,"abstract":"<p><strong>Purpose: </strong>Sacral neuromodulation (SNM) failure in fecal incontinence (FI) management represents a therapeutic challenge, often leading to more invasive, less accepted alternatives with inconsistent efficacy. In this context, intramural rectal botulinum toxin A (BoNT-A) injection has recently emerged as a promising minimally invasive alternative for urge FI. This study aimed to evaluate the effectiveness of intramural rectal BoNT-A injections in the challenging subgroup of SNM nonresponders.</p><p><strong>Methods: </strong>This retrospective, single-center study included patients with urge FI who underwent intramural rectal BoNT-A injections after SNM failure, between February 2018 and September 2024. The procedure involved endoscopic injection of 200 units of BoNT-A at 10 circumferential sites in the rectal wall. Treatment efficacy was assessed using the Cleveland Clinic Fecal Incontinence Score (CCFIS) and a visual analog scale (VAS) for symptom severity.</p><p><strong>Results: </strong>Fifteen female patients met the inclusion criteria, with a median follow-up of 22.5 months (range, 4.4-103.2 months). Patients received a median of 2 injections, with a median reinjection interval of 9.8 months. CCFIS scores demonstrated significant improvement (median, 15 [range, 8-20] vs. 8 [range, 0-20]; P=0.001), as did VAS symptom scores (median, 4 [range, 0-5] vs. 2 [range, 0-5]; P=0.001). No adverse events were reported.</p><p><strong>Conclusion: </strong>This study provides long-term evidence supporting intramural rectal BoNT-A injections as an effective option for managing urge FI, including as salvage therapy in SNM nonresponders. Further studies are necessary to confirm these findings and define the optimal role of BoNT-A within the therapeutic algorithm for urge FI.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"417-423"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of carbohydrate antigen 19-9 (CA19-9) change during immediate postoperative periods in patients with stage I-III colorectal cancer.","authors":"Wooram Choi, Yongjung Park, Jeonghyun Kang","doi":"10.3393/ac.2025.00528.0075","DOIUrl":"10.3393/ac.2025.00528.0075","url":null,"abstract":"<p><strong>Purpose: </strong>Although carbohydrate antigen 19-9 (CA19-9) may exhibit low sensitivity in tumor screening, its prognostic significance has been highlighted. This study assessed the significance of preoperative CA19-9 and early postoperative CA19-9 levels in patients with nonmetastatic colorectal cancer (CRC).</p><p><strong>Methods: </strong>Patients diagnosed with stage I-III CRC between January 2004 and April 2014 were included. Preoperative CA19-9 was assessed within 2 months of operation, whereas postoperative CA19-9 was measured 4 to 7 days after operation. The optimal cutoff values for preoperative and postoperative CA19-9 were established to maximize the differences in overall survival. Patients were categorized into 3 groups based on the CA19-9 change (CA19-9 trend): group 1, low preoperative CA19-9; group 2, high preoperative and low postoperative CA19-9; and group 3, high preoperative and postoperative CA19-9. The discriminatory powers of all variables were compared using the concordance index.</p><p><strong>Results: </strong>A total of 816 patients were included. The determined cutoff values for preoperative and postoperative CA19-9 were 18.9 and 21.4 U/mL, respectively. Subgroup dichotomization revealed associations of preoperative CA19-9, postoperative CA19-9, and CA19-9 trend with overall survival in univariable analysis. The CA19-9 trend emerged as an independent prognostic factor in the multivariable analysis (group 1 vs. group 2: hazard ratio, 1.682 [95% confidence interval (CI), 1.043-2.710], P=0.032; group 1 vs. group 3: hazard ratio, 2.882 [95% CI, 1.899-4.371], P<0.001). The concordance index value of the CA19-9 trend (0.636; 95% CI, 0.509-0.682) surpassed those of preoperative and postoperative CA19-9.</p><p><strong>Conclusion: </strong>The amalgamation of preoperative and postoperative CA19-9 levels demonstrated enhanced prognostic stratification, allowing for a more detailed classification of patients with nonmetastatic CRC.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"400-408"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and clinical significance of evacuation disorders in patients with low anterior resection syndrome.","authors":"Yuko Homma, Toshiki Mimura, Koji Koinuma, Hisanaga Horie, Naohiro Sata","doi":"10.3393/ac.2024.00934.0133","DOIUrl":"10.3393/ac.2024.00934.0133","url":null,"abstract":"<p><strong>Purpose: </strong>Low anterior resection syndrome (LARS) manifests with evacuation disorder symptoms and continence problems. However, no prior study has focused on evacuation disorders in patients with LARS. This study investigated the prevalence of evacuation disorders and their association with the LARS score.</p><p><strong>Methods: </strong>This study included patients with defecation per anus at the time of the survey, which was conducted between November 2020 and April 2021. These patients had undergone anus-preserving surgery for rectal tumors between 2014 and 2019 at a tertiary university hospital. The severity of evacuation disorders and LARS was evaluated using the Constipation Scoring System and the LARS score, respectively. The primary endpoint was the prevalence of evacuation disorders, defined as evacuation difficulty, feeling of incomplete evacuation, and abnormally long time on the toilet. The secondary endpoints were the associations between these symptoms and the LARS score.</p><p><strong>Results: </strong>Of 332 eligible patients, 238 (71.7%) completed the questionnaire. The overall prevalence of evacuation disorders was 48.3%. The rates of feeling incomplete evacuation, evacuation difficulty, and prolonged time on the toilet were 45.6%, 15.5%, and 8.4%, respectively. Patients with minor or major LARS had a significantly higher prevalence of evacuation disorders than those with no LARS, particularly regarding feeling incomplete evacuation.</p><p><strong>Conclusions: </strong>Evacuation disorders were present in 48.3% of patients following anus-preserving surgery. Greater severity of LARS was associated with a higher prevalence of evacuation disorders, especially a feeling of incomplete evacuation. Patients should be informed about the potential for both evacuation disorders and continence-related symptoms following anus-preserving surgery.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"271-278"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved outcomes with cyanoacrylate glue for ileocolic anastomosis in right colectomy: a multicenter study.","authors":"Daniela Rega, Ernesto De Giulio, Raffaele De Luca, Andrea Muratore, Marco Milone, Giuseppe Sica, Paolo Millo, Carmela Cervone, Nicola Cillara, Patrizia Marsanic, Brunella Maria Pirozzi, Valeria Grazia Malagnino, Pietro Anoldo, Marcello Calabrò, Giovanni De Palma, Michele Simone, Paolo Delrio","doi":"10.3393/ac.2024.00899.0128","DOIUrl":"10.3393/ac.2024.00899.0128","url":null,"abstract":"<p><strong>Purpose: </strong>Anastomotic leaks (AL) remain a major complication following right colectomy for colon cancer. This multicenter, prospective, observational study evaluated the efficacy of Glubran 2, a cyanoacrylate-based sealant, in reducing the incidence of AL by reinforcing ileocolic anastomoses.</p><p><strong>Methods: </strong>The study enrolled 380 patients undergoing right colectomy for colon cancer across 7 Italian hospitals. Glubran 2 was applied to reinforce ileocolic anastomoses. The primary endpoint was a 50% reduction in AL incidence from a baseline of 6.18% within 10 days after surgery. Secondary endpoints included examining the correlation between AL and preexisting risk factors and determining the rate of anastomotic bleeding. Statistical analyses employed binomial tests and logistic regression.</p><p><strong>Results: </strong>The AL rate was reduced to 1.85% compared to the reference rate of 6.18% (P<0.01). Glubran 2 exhibited a protective effect even in patients with preexisting risk factors such as smoking, diabetes, or prior surgeries; none of these factors was significantly associated with AL (P>0.05). Surgical technique (P=0.687), anastomosis technique (P=0.998), and anastomosis type (P=0.998) did not influence AL rates. Operation time was similar across groups (P=0.613), and anastomotic bleeding occurred in 1.3% of cases, with no association with AL (P=0.989).</p><p><strong>Conclusions: </strong>Glubran 2 was safely applied to ileocolic anastomoses, significantly reducing AL rates and potentially providing a protective effect even in patients with known risk factors. Its hemostatic and bacteriostatic properties support improved postoperative outcomes, highlighting its potential as an effective adjunct in colorectal surgery. Further studies are warranted to confirm these findings and explore broader applications.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"293-302"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the boundaries of minimally invasive surgery: the feasibility of robotic natural orifice transluminal extraction colectomy and robotic no-incision colectomy in colorectal practice.","authors":"Thalia Petropoulou, Kyriacos Evangelou, Andreas Polydorou","doi":"10.3393/ac.2025.00647.0092","DOIUrl":"10.3393/ac.2025.00647.0092","url":null,"abstract":"<p><strong>Purpose: </strong>Minimally invasive surgery offers reduced trauma, accelerated recovery, and shorter hospital stays. Robotic technology further enhances laparoscopic precision, particularly in colorectal procedures. This study investigated the safety and effectiveness of robotic natural orifice transluminal extraction colectomy (R-NOTEC) and robotic no-incision colectomy (R-NIC), comparing these techniques to the conventional robotic colectomy.</p><p><strong>Methods: </strong>Outcomes of patients undergoing robotic-assisted colorectal resection-either conventional robotic colectomy or R-NOTEC/R-NIC-using a single docking technique at a tertiary hospital over 3 years were analyzed. All patients were managed according to established Enhanced Recovery After Surgery protocols.</p><p><strong>Results: </strong>In total, 100 patients were included, with 25 receiving R-NOTEC or R-NIC. The median age was 65 years (range, 30-82 years), and the median body mass index was 31.0 kg/m2 (range, 20.1-43.0 kg/m2). The median length of stay was significantly shorter in the R-NOTEC/R-NIC group than in the conventional robotic group (2.0 days vs. 3.4 days, P=0.021). Other outcomes, such as circumferential resection margin status, lymph node yield, and mortality, were similar between groups. The R-NOTEC/R-NIC group exhibited a slightly lower complication rate, as well as less opioid use. No conversions to open surgery occurred in either group.</p><p><strong>Conclusions: </strong>R-NOTEC/R-NIC offer significant promise in colorectal surgery by minimizing trauma, expediting recovery, and maintaining oncologic safety. Nevertheless, these procedures require specialized surgical expertise and careful patient selection. Further research should focus on long-term outcomes and standardization of these techniques. .</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"346-353"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of chyle leakage between laparoscopic and open colectomy in patients with colon cancer: a systematic review and meta-analysis.","authors":"Tharin Thampongsa, Sitanun Saengsri, Pichet Wattanapreechanoni, Chairat Supsamutchai, Chumpon Wilasrusmee, Napaphat Poprom","doi":"10.3393/ac.2025.00045.0006","DOIUrl":"10.3393/ac.2025.00045.0006","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic complete mesocolon excision (LCME) for right colonic cancer improves oncological outcomes. This meta-analysis aimed to compare the rate of chylous leakage between laparoscopic and open right colectomy with CME for right-sided colonic cancers.</p><p><strong>Methods: </strong>A literature search was performed up to February 2022. The primary outcome was the rate of chylous leakage. Secondary outcomes included related surgical and clinical parameters. A meta-analysis was performed to calculate risk ratios.</p><p><strong>Results: </strong>Eleven studies were included. The rate of postoperative chylous leakage was lower in laparoscopic surgery compared to open surgery (risk ratio, 0.63; 95% confidence interval, 0.33-1.20), although this difference was not statistically significant. LCME showed superior outcomes to open CME (OCME) in secondary outcomes, such as reduced blood loss, increased harvested lymph node count, and decreased overall morbidity.</p><p><strong>Conclusions: </strong>There was no significant difference between LCME and OCME regarding the rates of chylous leakage, anastomosis leakage, or operative time. However, LCME demonstrated superiority in blood loss reduction, harvested lymph node number, and overall morbidity in patients undergoing surgery for right colon cancer.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"262-270"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racing toward the future of robot-assisted rectal cancer surgery: a comparative study of hinotori and da Vinci.","authors":"Sung Uk Bae","doi":"10.3393/ac.2025.00990.0141","DOIUrl":"10.3393/ac.2025.00990.0141","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"259-261"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incisional hernia risk in intracorporeal anastomosis with Pfannenstiel incision versus extracorporeal anastomosis with midline incision for laparoscopic right hemicolectomy: a multicenter comparison.","authors":"Francesco Saverio Lucido, Giusiana Nesta, Luigi Brusciano, Claudio Gambardella, Francesco Pizza, Giuseppe Scognamiglio, Gianmattia Del Genio, Salvatore Tolone, Federico Maria Mongardini, Massimo Mongardini, Ludovico Docimo, Simona Parisi","doi":"10.3393/ac.2024.00682.0097","DOIUrl":"10.3393/ac.2024.00682.0097","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic right hemicolectomy can be performed via intracorporeal ileocolic anastomosis (ICA) or extracorporeal ileocolic anastomosis (ECA). Prior studies have emphasized ICA's advantages in hospital stay and postoperative pain. This multicenter study aimed to compare the 2-year incidence of incisional hernia between ICA (using a suprapubic Pfannenstiel incision) and ECA (using a pararectal incision) and assess perioperative outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed patients undergoing laparoscopic right hemicolectomy between 2019 and 2020, divided into 2 groups: ICA with a Pfannenstiel incision and ECA with a pararectal incision.</p><p><strong>Results: </strong>The mean operative time was longer in the ICA group (190 minutes vs. 170 minutes, P=0.004). Despite requiring advanced surgical skills and prolonged operative time, ICA was associated with superior short-term outcomes and a significantly lower incisional hernia rate compared to ECA (1.2% vs. 14.7%, P=0.044) at 24-month follow-up.</p><p><strong>Conclusions: </strong>ICA is linked to longer operative times, but shorter hospital stays, fewer wound complications, and reduced incisional hernia rates compared to ECA.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"287-292"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}