Advance in diagnosis and treatment of small bowel tumors: a single-center report
Background The past decade has seen significant advances in the evaluation of the small bowel, long considered as the “black box” in gastroenterology. The development of several endoscopic techniques, including capsule endoscopy (CE) and double (DBE)- and single (SBE)-balloon enteroscopy, has improv...
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| description | Background
The past decade has seen significant advances in the evaluation of the small bowel, long considered as the “black box” in gastroenterology. The development of several endoscopic techniques, including capsule endoscopy (CE) and double (DBE)- and single (SBE)-balloon enteroscopy, has improved the evaluation of this part of the gut and led to reach a more precise preoperative diagnosis of small-bowel tumors. These rare tumors were previously diagnosed only after laparotomy, although laparoscopic advanced surgery can be used for minimally invasive therapeutic approach in these patients. This study was designed to evaluate the diagnostic and therapeutic impact of endoscopic procedures on small-bowel tumors.
Methods
During October 2010, 148 SBE procedures were performed; in 14 patients (7 males and 7 females, mean age 58.8 years; range 37–82 years) who suffered from obscure gastrointestinal bleeding, with previous negative upper and lower GI endoscopy, a diagnosis of small-bowel tumor was suspected according to CT scan (7 cases) and/or CE (11 patients). Then, an enteroscopy was performed.
Results
Multiple biopsies were taken in 9 cases; endoscopic tattoos were performed in 11 cases. After endoscopic procedures, histological examination showed melanoma in one case, adenocarcinoma in seven, and adenoma in one case. In 11 of 14 patients, a laparoscopic partial resection of small bowel involved was possible due to endoscopic tattoos. In one patient, the involvement of colic segment precluded a laparoscopic resection. In two patients, the laparoscopic resection was not possible for technical problems. Histological findings on resected specimens were indicative for melanoma in one case, gastrointestinal stromal tumor (GIST) in four cases, gastrointestinal autonomic nerve tumor (GANT) in one case, adenoma in one, and adenocarcinoma in seven cases.
Conclusions
New development of different endoscopic approaches to the small bowel has led to reach an earlier diagnosis of small-bowel tumors and a preoperative diagnosis with consequent minimally invasive surgical approach. |
| doi_str_mv | 10.1007/s00464-011-1896-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_917159490</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>917159490</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-e2c61a4ed4334ebbb4697b13d1b46e956d8a4df4f637d68c560386a6102e2dbd3</originalsourceid><addsrcrecordid>eNp10E1r3DAQBmBRWpJt2h_QSxGF0JPakSzLVm4h9AsC7SE5C9kaLw62tNXYDf33UbKbBgI9aUDPfPAy9k7CJwnQfCYAbbQAKYVsrRHmBdtIXSmhlGxfsg3YCoRqrD5mr4luoHAr6yN2rKQF29Zqw36dhz8-9sjHyMPotzHRSNzHwJeMfpkxLjwNnGY_TbxLtzjxZZ1TpjPuOY1xO6HoC8LMM-5SXt6wV4OfCN8e3hN2_fXL1cV3cfnz24-L80vRa4BFoOqN9BqDriqNXddpY5tOVkGWCm1tQut1GPRgqiaYtq8NVK3xRoJCFbpQnbCP-7m7nH6vSIubR-pxmnzEtJKzspG11RaK_PBM3qQ1x3JcQaZRAA9I7lGfE1HGwe3yOPv810lw92G7fdiuhO3uw3am9Lw_DF67GcO_jsd0Czg9AE-9n4Zckh7pydW10vDg1N5R-YpbzE8X_n_7HRazldQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>916720090</pqid></control><display><type>article</type><title>Advance in diagnosis and treatment of small bowel tumors: a single-center report</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Riccioni, M. E. ; Cianci, R. ; Urgesi, R. ; Bizzotto, A. ; Spada, C. ; Rizzo, G. ; Coco, C. ; Costamagna, G.</creator><creatorcontrib>Riccioni, M. E. ; Cianci, R. ; Urgesi, R. ; Bizzotto, A. ; Spada, C. ; Rizzo, G. ; Coco, C. ; Costamagna, G.</creatorcontrib><description>Background
The past decade has seen significant advances in the evaluation of the small bowel, long considered as the “black box” in gastroenterology. The development of several endoscopic techniques, including capsule endoscopy (CE) and double (DBE)- and single (SBE)-balloon enteroscopy, has improved the evaluation of this part of the gut and led to reach a more precise preoperative diagnosis of small-bowel tumors. These rare tumors were previously diagnosed only after laparotomy, although laparoscopic advanced surgery can be used for minimally invasive therapeutic approach in these patients. This study was designed to evaluate the diagnostic and therapeutic impact of endoscopic procedures on small-bowel tumors.
Methods
During October 2010, 148 SBE procedures were performed; in 14 patients (7 males and 7 females, mean age 58.8 years; range 37–82 years) who suffered from obscure gastrointestinal bleeding, with previous negative upper and lower GI endoscopy, a diagnosis of small-bowel tumor was suspected according to CT scan (7 cases) and/or CE (11 patients). Then, an enteroscopy was performed.
Results
Multiple biopsies were taken in 9 cases; endoscopic tattoos were performed in 11 cases. After endoscopic procedures, histological examination showed melanoma in one case, adenocarcinoma in seven, and adenoma in one case. In 11 of 14 patients, a laparoscopic partial resection of small bowel involved was possible due to endoscopic tattoos. In one patient, the involvement of colic segment precluded a laparoscopic resection. In two patients, the laparoscopic resection was not possible for technical problems. Histological findings on resected specimens were indicative for melanoma in one case, gastrointestinal stromal tumor (GIST) in four cases, gastrointestinal autonomic nerve tumor (GANT) in one case, adenoma in one, and adenocarcinoma in seven cases.
Conclusions
New development of different endoscopic approaches to the small bowel has led to reach an earlier diagnosis of small-bowel tumors and a preoperative diagnosis with consequent minimally invasive surgical approach.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-011-1896-6</identifier><identifier>PMID: 21909852</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biopsy ; Bowel disease ; Cancer ; Capsule Endoscopy ; Digestive system. Abdomen ; Double-Balloon Enteroscopy ; Early Detection of Cancer ; Endoscopy ; Endoscopy, Gastrointestinal - instrumentation ; Endoscopy, Gastrointestinal - methods ; Equipment Design ; Female ; Gastroenterology ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Gynecology ; Hepatology ; Histology ; Humans ; Intestinal Neoplasms - diagnosis ; Intestinal Neoplasms - surgery ; Intestine, Small ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopy ; Laparotomy ; Length of Stay ; Male ; Medical diagnosis ; Medical imaging ; Medical sciences ; Medicine ; Medicine & Public Health ; Melanoma ; Middle Aged ; Proctology ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgeons ; Surgery ; Tattoos ; Tumors</subject><ispartof>Surgical endoscopy, 2012-02, Vol.26 (2), p.438-441</ispartof><rights>Springer Science+Business Media, LLC 2011</rights><rights>2015 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-e2c61a4ed4334ebbb4697b13d1b46e956d8a4df4f637d68c560386a6102e2dbd3</citedby><cites>FETCH-LOGICAL-c400t-e2c61a4ed4334ebbb4697b13d1b46e956d8a4df4f637d68c560386a6102e2dbd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-011-1896-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-011-1896-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25524052$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21909852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Riccioni, M. E.</creatorcontrib><creatorcontrib>Cianci, R.</creatorcontrib><creatorcontrib>Urgesi, R.</creatorcontrib><creatorcontrib>Bizzotto, A.</creatorcontrib><creatorcontrib>Spada, C.</creatorcontrib><creatorcontrib>Rizzo, G.</creatorcontrib><creatorcontrib>Coco, C.</creatorcontrib><creatorcontrib>Costamagna, G.</creatorcontrib><title>Advance in diagnosis and treatment of small bowel tumors: a single-center report</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
The past decade has seen significant advances in the evaluation of the small bowel, long considered as the “black box” in gastroenterology. The development of several endoscopic techniques, including capsule endoscopy (CE) and double (DBE)- and single (SBE)-balloon enteroscopy, has improved the evaluation of this part of the gut and led to reach a more precise preoperative diagnosis of small-bowel tumors. These rare tumors were previously diagnosed only after laparotomy, although laparoscopic advanced surgery can be used for minimally invasive therapeutic approach in these patients. This study was designed to evaluate the diagnostic and therapeutic impact of endoscopic procedures on small-bowel tumors.
Methods
During October 2010, 148 SBE procedures were performed; in 14 patients (7 males and 7 females, mean age 58.8 years; range 37–82 years) who suffered from obscure gastrointestinal bleeding, with previous negative upper and lower GI endoscopy, a diagnosis of small-bowel tumor was suspected according to CT scan (7 cases) and/or CE (11 patients). Then, an enteroscopy was performed.
Results
Multiple biopsies were taken in 9 cases; endoscopic tattoos were performed in 11 cases. After endoscopic procedures, histological examination showed melanoma in one case, adenocarcinoma in seven, and adenoma in one case. In 11 of 14 patients, a laparoscopic partial resection of small bowel involved was possible due to endoscopic tattoos. In one patient, the involvement of colic segment precluded a laparoscopic resection. In two patients, the laparoscopic resection was not possible for technical problems. Histological findings on resected specimens were indicative for melanoma in one case, gastrointestinal stromal tumor (GIST) in four cases, gastrointestinal autonomic nerve tumor (GANT) in one case, adenoma in one, and adenocarcinoma in seven cases.
Conclusions
New development of different endoscopic approaches to the small bowel has led to reach an earlier diagnosis of small-bowel tumors and a preoperative diagnosis with consequent minimally invasive surgical approach.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Bowel disease</subject><subject>Cancer</subject><subject>Capsule Endoscopy</subject><subject>Digestive system. Abdomen</subject><subject>Double-Balloon Enteroscopy</subject><subject>Early Detection of Cancer</subject><subject>Endoscopy</subject><subject>Endoscopy, Gastrointestinal - instrumentation</subject><subject>Endoscopy, Gastrointestinal - methods</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Histology</subject><subject>Humans</subject><subject>Intestinal Neoplasms - diagnosis</subject><subject>Intestinal Neoplasms - surgery</subject><subject>Intestine, Small</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopy</subject><subject>Laparotomy</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melanoma</subject><subject>Middle Aged</subject><subject>Proctology</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Tattoos</subject><subject>Tumors</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp10E1r3DAQBmBRWpJt2h_QSxGF0JPakSzLVm4h9AsC7SE5C9kaLw62tNXYDf33UbKbBgI9aUDPfPAy9k7CJwnQfCYAbbQAKYVsrRHmBdtIXSmhlGxfsg3YCoRqrD5mr4luoHAr6yN2rKQF29Zqw36dhz8-9sjHyMPotzHRSNzHwJeMfpkxLjwNnGY_TbxLtzjxZZ1TpjPuOY1xO6HoC8LMM-5SXt6wV4OfCN8e3hN2_fXL1cV3cfnz24-L80vRa4BFoOqN9BqDriqNXddpY5tOVkGWCm1tQut1GPRgqiaYtq8NVK3xRoJCFbpQnbCP-7m7nH6vSIubR-pxmnzEtJKzspG11RaK_PBM3qQ1x3JcQaZRAA9I7lGfE1HGwe3yOPv810lw92G7fdiuhO3uw3am9Lw_DF67GcO_jsd0Czg9AE-9n4Zckh7pydW10vDg1N5R-YpbzE8X_n_7HRazldQ</recordid><startdate>20120201</startdate><enddate>20120201</enddate><creator>Riccioni, M. E.</creator><creator>Cianci, R.</creator><creator>Urgesi, R.</creator><creator>Bizzotto, A.</creator><creator>Spada, C.</creator><creator>Rizzo, G.</creator><creator>Coco, C.</creator><creator>Costamagna, G.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20120201</creationdate><title>Advance in diagnosis and treatment of small bowel tumors: a single-center report</title><author>Riccioni, M. E. ; Cianci, R. ; Urgesi, R. ; Bizzotto, A. ; Spada, C. ; Rizzo, G. ; Coco, C. ; Costamagna, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-e2c61a4ed4334ebbb4697b13d1b46e956d8a4df4f637d68c560386a6102e2dbd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Bowel disease</topic><topic>Cancer</topic><topic>Capsule Endoscopy</topic><topic>Digestive system. Abdomen</topic><topic>Double-Balloon Enteroscopy</topic><topic>Early Detection of Cancer</topic><topic>Endoscopy</topic><topic>Endoscopy, Gastrointestinal - instrumentation</topic><topic>Endoscopy, Gastrointestinal - methods</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Histology</topic><topic>Humans</topic><topic>Intestinal Neoplasms - diagnosis</topic><topic>Intestinal Neoplasms - surgery</topic><topic>Intestine, Small</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopy</topic><topic>Laparotomy</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Melanoma</topic><topic>Middle Aged</topic><topic>Proctology</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Tattoos</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Riccioni, M. E.</creatorcontrib><creatorcontrib>Cianci, R.</creatorcontrib><creatorcontrib>Urgesi, R.</creatorcontrib><creatorcontrib>Bizzotto, A.</creatorcontrib><creatorcontrib>Spada, C.</creatorcontrib><creatorcontrib>Rizzo, G.</creatorcontrib><creatorcontrib>Coco, C.</creatorcontrib><creatorcontrib>Costamagna, G.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Riccioni, M. E.</au><au>Cianci, R.</au><au>Urgesi, R.</au><au>Bizzotto, A.</au><au>Spada, C.</au><au>Rizzo, G.</au><au>Coco, C.</au><au>Costamagna, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Advance in diagnosis and treatment of small bowel tumors: a single-center report</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2012-02-01</date><risdate>2012</risdate><volume>26</volume><issue>2</issue><spage>438</spage><epage>441</epage><pages>438-441</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background
The past decade has seen significant advances in the evaluation of the small bowel, long considered as the “black box” in gastroenterology. The development of several endoscopic techniques, including capsule endoscopy (CE) and double (DBE)- and single (SBE)-balloon enteroscopy, has improved the evaluation of this part of the gut and led to reach a more precise preoperative diagnosis of small-bowel tumors. These rare tumors were previously diagnosed only after laparotomy, although laparoscopic advanced surgery can be used for minimally invasive therapeutic approach in these patients. This study was designed to evaluate the diagnostic and therapeutic impact of endoscopic procedures on small-bowel tumors.
Methods
During October 2010, 148 SBE procedures were performed; in 14 patients (7 males and 7 females, mean age 58.8 years; range 37–82 years) who suffered from obscure gastrointestinal bleeding, with previous negative upper and lower GI endoscopy, a diagnosis of small-bowel tumor was suspected according to CT scan (7 cases) and/or CE (11 patients). Then, an enteroscopy was performed.
Results
Multiple biopsies were taken in 9 cases; endoscopic tattoos were performed in 11 cases. After endoscopic procedures, histological examination showed melanoma in one case, adenocarcinoma in seven, and adenoma in one case. In 11 of 14 patients, a laparoscopic partial resection of small bowel involved was possible due to endoscopic tattoos. In one patient, the involvement of colic segment precluded a laparoscopic resection. In two patients, the laparoscopic resection was not possible for technical problems. Histological findings on resected specimens were indicative for melanoma in one case, gastrointestinal stromal tumor (GIST) in four cases, gastrointestinal autonomic nerve tumor (GANT) in one case, adenoma in one, and adenocarcinoma in seven cases.
Conclusions
New development of different endoscopic approaches to the small bowel has led to reach an earlier diagnosis of small-bowel tumors and a preoperative diagnosis with consequent minimally invasive surgical approach.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>21909852</pmid><doi>10.1007/s00464-011-1896-6</doi><tpages>4</tpages></addata></record> |
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| subjects | Abdominal Surgery Adult Aged Aged, 80 and over Biological and medical sciences Biopsy Bowel disease Cancer Capsule Endoscopy Digestive system. Abdomen Double-Balloon Enteroscopy Early Detection of Cancer Endoscopy Endoscopy, Gastrointestinal - instrumentation Endoscopy, Gastrointestinal - methods Equipment Design Female Gastroenterology Gastroenterology. Liver. Pancreas. Abdomen General aspects Gynecology Hepatology Histology Humans Intestinal Neoplasms - diagnosis Intestinal Neoplasms - surgery Intestine, Small Investigative techniques, diagnostic techniques (general aspects) Laparoscopy Laparotomy Length of Stay Male Medical diagnosis Medical imaging Medical sciences Medicine Medicine & Public Health Melanoma Middle Aged Proctology Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgeons Surgery Tattoos Tumors |
| title | Advance in diagnosis and treatment of small bowel tumors: a single-center report |
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