A Comparison of Total Thoracoscopic and Robotic Surgery for Lung Cancer Lymphadenectomy
Robotic-assisted thoracic surgery (RATS) is used increasingly frequently in major lung resection for early stage non-small-cell lung cancer (NSCLC) but has not yet been fully evaluated. The aim of this study was to compare the surgical outcomes of lymph node dissection (LND) performed via RATS with...
Gespeichert in:
| Veröffentlicht in: | Cancers 2023-06, Vol.15 (13), p.3442 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 13 |
| container_start_page | 3442 |
| container_title | Cancers |
| container_volume | 15 |
| creator | Ureña, Anna Moreno, Camilo Macia, Ivan Rivas, Francisco Déniz, Carlos Muñoz, Anna Serratosa, Ines García, Marta Masuet-Aumatell, Cristina Escobar, Ignacio Ramos, Ricard |
| description | Robotic-assisted thoracic surgery (RATS) is used increasingly frequently in major lung resection for early stage non-small-cell lung cancer (NSCLC) but has not yet been fully evaluated. The aim of this study was to compare the surgical outcomes of lymph node dissection (LND) performed via RATS with those from totally thoracoscopic (TT) four-port videothoracoscopy.
Clinical and pathological data were collected retrospectively from patients with clinical stage N0 NSCLC who underwent pulmonary resection in the form of lobectomy or segmental resection between June 2010 and November 2022. The assessment criteria were number of mediastinal lymph nodes and number of mediastinal stations dissected via the RATS approach compared with the four-port TT approach.
A total of 246 pulmonary resections with LND for clinical stages I-II NSCLC were performed: 85 via TT and 161 via RATS. The clinical characteristics of the patients were similar in both groups. The number of mediastinal nodes dissected and mediastinal stations dissected was significantly higher in the RATS group (TT: mean ± SD, 10.72 ± 3.7; RATS, 14.74 ± 6.3 [
< 0.001]), except in the inferior mediastinal stations. There was no difference in terms of postoperative complications.
In patients with early stage NSCLC undergoing major lung resection, the quality of hilomediastinal LND performed using RATS was superior to that performed using TT. |
| doi_str_mv | 10.3390/cancers15133442 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10341346</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A757714486</galeid><sourcerecordid>A757714486</sourcerecordid><originalsourceid>FETCH-LOGICAL-c489t-b8ee74adc46b7179dbb36eeef2ece82cd3428dfe4a37bd0b3c4c9a19ffa8e72b3</originalsourceid><addsrcrecordid>eNptUk1r3DAQFaWlCZuceyuCXnrZxPqwZZ_KsvQLFgrJhh6FJI92HWyNK9mB_ffVNmmahEoHDdJ7b2aehpB3rLgQoikunQkOYmIlE0JK_oqc8kLxZVU18vWT-IScp3Rb5CUEU5V6S06EklKWZXlKfq7oGofRxC5hoOjpFifT0-0eo3GYHI6doya09AotTjm-nuMO4oF6jHQzhx1d_6mCbg7DuDctBHATDocz8sabPsH5w7kgN18-b9fflpsfX7-vV5ulk3UzLW0NoKRpnaysYqpprRUVAHgODmruWiF53XqQRijbFlY46RrDGu9NDYpbsSCf7nXH2Q7QOghTNL0eYzeYeNBoOv38JXR7vcM7zQohmZBVVvj4oBDx1wxp0kOXHPS9CYBz0rwWNc92ZfcW5MML6C3OMeT-jqhKyIKz8h9qZ3rQXfCYE7ujqF6pUikmZX1Me_EfVN4tDJ3DAL7L988Il_cEFzGlCP6xSVbo4zzoF_OQGe-fevOI__v74jejarKy</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2836340215</pqid></control><display><type>article</type><title>A Comparison of Total Thoracoscopic and Robotic Surgery for Lung Cancer Lymphadenectomy</title><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Ureña, Anna ; Moreno, Camilo ; Macia, Ivan ; Rivas, Francisco ; Déniz, Carlos ; Muñoz, Anna ; Serratosa, Ines ; García, Marta ; Masuet-Aumatell, Cristina ; Escobar, Ignacio ; Ramos, Ricard</creator><creatorcontrib>Ureña, Anna ; Moreno, Camilo ; Macia, Ivan ; Rivas, Francisco ; Déniz, Carlos ; Muñoz, Anna ; Serratosa, Ines ; García, Marta ; Masuet-Aumatell, Cristina ; Escobar, Ignacio ; Ramos, Ricard</creatorcontrib><description>Robotic-assisted thoracic surgery (RATS) is used increasingly frequently in major lung resection for early stage non-small-cell lung cancer (NSCLC) but has not yet been fully evaluated. The aim of this study was to compare the surgical outcomes of lymph node dissection (LND) performed via RATS with those from totally thoracoscopic (TT) four-port videothoracoscopy.
Clinical and pathological data were collected retrospectively from patients with clinical stage N0 NSCLC who underwent pulmonary resection in the form of lobectomy or segmental resection between June 2010 and November 2022. The assessment criteria were number of mediastinal lymph nodes and number of mediastinal stations dissected via the RATS approach compared with the four-port TT approach.
A total of 246 pulmonary resections with LND for clinical stages I-II NSCLC were performed: 85 via TT and 161 via RATS. The clinical characteristics of the patients were similar in both groups. The number of mediastinal nodes dissected and mediastinal stations dissected was significantly higher in the RATS group (TT: mean ± SD, 10.72 ± 3.7; RATS, 14.74 ± 6.3 [
< 0.001]), except in the inferior mediastinal stations. There was no difference in terms of postoperative complications.
In patients with early stage NSCLC undergoing major lung resection, the quality of hilomediastinal LND performed using RATS was superior to that performed using TT.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers15133442</identifier><identifier>PMID: 37444555</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Cancer surgery ; Cardiac arrhythmia ; Chronic obstructive pulmonary disease ; Comparative analysis ; Complications ; Dissection ; Hospitals ; Infections ; Laparoscopy ; Lung cancer ; Lung cancer, Non-small cell ; Lymph nodes ; Lymphatic system ; Medical prognosis ; Mortality ; Non-small cell lung carcinoma ; Normal distribution ; Patients ; Pneumonia ; Postoperative ; Robotic surgery ; Robotics ; Robots ; Small cell lung carcinoma ; Thoracic surgery ; Thorax ; Tomography ; Tumors</subject><ispartof>Cancers, 2023-06, Vol.15 (13), p.3442</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-b8ee74adc46b7179dbb36eeef2ece82cd3428dfe4a37bd0b3c4c9a19ffa8e72b3</citedby><cites>FETCH-LOGICAL-c489t-b8ee74adc46b7179dbb36eeef2ece82cd3428dfe4a37bd0b3c4c9a19ffa8e72b3</cites><orcidid>0000-0001-5557-9812 ; 0000-0001-7000-7345 ; 0009-0005-8632-830X ; 0000-0002-5718-8900 ; 0000-0002-3789-2052</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10341346/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10341346/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37444555$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ureña, Anna</creatorcontrib><creatorcontrib>Moreno, Camilo</creatorcontrib><creatorcontrib>Macia, Ivan</creatorcontrib><creatorcontrib>Rivas, Francisco</creatorcontrib><creatorcontrib>Déniz, Carlos</creatorcontrib><creatorcontrib>Muñoz, Anna</creatorcontrib><creatorcontrib>Serratosa, Ines</creatorcontrib><creatorcontrib>García, Marta</creatorcontrib><creatorcontrib>Masuet-Aumatell, Cristina</creatorcontrib><creatorcontrib>Escobar, Ignacio</creatorcontrib><creatorcontrib>Ramos, Ricard</creatorcontrib><title>A Comparison of Total Thoracoscopic and Robotic Surgery for Lung Cancer Lymphadenectomy</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>Robotic-assisted thoracic surgery (RATS) is used increasingly frequently in major lung resection for early stage non-small-cell lung cancer (NSCLC) but has not yet been fully evaluated. The aim of this study was to compare the surgical outcomes of lymph node dissection (LND) performed via RATS with those from totally thoracoscopic (TT) four-port videothoracoscopy.
Clinical and pathological data were collected retrospectively from patients with clinical stage N0 NSCLC who underwent pulmonary resection in the form of lobectomy or segmental resection between June 2010 and November 2022. The assessment criteria were number of mediastinal lymph nodes and number of mediastinal stations dissected via the RATS approach compared with the four-port TT approach.
A total of 246 pulmonary resections with LND for clinical stages I-II NSCLC were performed: 85 via TT and 161 via RATS. The clinical characteristics of the patients were similar in both groups. The number of mediastinal nodes dissected and mediastinal stations dissected was significantly higher in the RATS group (TT: mean ± SD, 10.72 ± 3.7; RATS, 14.74 ± 6.3 [
< 0.001]), except in the inferior mediastinal stations. There was no difference in terms of postoperative complications.
In patients with early stage NSCLC undergoing major lung resection, the quality of hilomediastinal LND performed using RATS was superior to that performed using TT.</description><subject>Cancer surgery</subject><subject>Cardiac arrhythmia</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Comparative analysis</subject><subject>Complications</subject><subject>Dissection</subject><subject>Hospitals</subject><subject>Infections</subject><subject>Laparoscopy</subject><subject>Lung cancer</subject><subject>Lung cancer, Non-small cell</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Non-small cell lung carcinoma</subject><subject>Normal distribution</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Postoperative</subject><subject>Robotic surgery</subject><subject>Robotics</subject><subject>Robots</subject><subject>Small cell lung carcinoma</subject><subject>Thoracic surgery</subject><subject>Thorax</subject><subject>Tomography</subject><subject>Tumors</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptUk1r3DAQFaWlCZuceyuCXnrZxPqwZZ_KsvQLFgrJhh6FJI92HWyNK9mB_ffVNmmahEoHDdJ7b2aehpB3rLgQoikunQkOYmIlE0JK_oqc8kLxZVU18vWT-IScp3Rb5CUEU5V6S06EklKWZXlKfq7oGofRxC5hoOjpFifT0-0eo3GYHI6doya09AotTjm-nuMO4oF6jHQzhx1d_6mCbg7DuDctBHATDocz8sabPsH5w7kgN18-b9fflpsfX7-vV5ulk3UzLW0NoKRpnaysYqpprRUVAHgODmruWiF53XqQRijbFlY46RrDGu9NDYpbsSCf7nXH2Q7QOghTNL0eYzeYeNBoOv38JXR7vcM7zQohmZBVVvj4oBDx1wxp0kOXHPS9CYBz0rwWNc92ZfcW5MML6C3OMeT-jqhKyIKz8h9qZ3rQXfCYE7ujqF6pUikmZX1Me_EfVN4tDJ3DAL7L988Il_cEFzGlCP6xSVbo4zzoF_OQGe-fevOI__v74jejarKy</recordid><startdate>20230630</startdate><enddate>20230630</enddate><creator>Ureña, Anna</creator><creator>Moreno, Camilo</creator><creator>Macia, Ivan</creator><creator>Rivas, Francisco</creator><creator>Déniz, Carlos</creator><creator>Muñoz, Anna</creator><creator>Serratosa, Ines</creator><creator>García, Marta</creator><creator>Masuet-Aumatell, Cristina</creator><creator>Escobar, Ignacio</creator><creator>Ramos, Ricard</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5557-9812</orcidid><orcidid>https://orcid.org/0000-0001-7000-7345</orcidid><orcidid>https://orcid.org/0009-0005-8632-830X</orcidid><orcidid>https://orcid.org/0000-0002-5718-8900</orcidid><orcidid>https://orcid.org/0000-0002-3789-2052</orcidid></search><sort><creationdate>20230630</creationdate><title>A Comparison of Total Thoracoscopic and Robotic Surgery for Lung Cancer Lymphadenectomy</title><author>Ureña, Anna ; Moreno, Camilo ; Macia, Ivan ; Rivas, Francisco ; Déniz, Carlos ; Muñoz, Anna ; Serratosa, Ines ; García, Marta ; Masuet-Aumatell, Cristina ; Escobar, Ignacio ; Ramos, Ricard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-b8ee74adc46b7179dbb36eeef2ece82cd3428dfe4a37bd0b3c4c9a19ffa8e72b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cancer surgery</topic><topic>Cardiac arrhythmia</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Comparative analysis</topic><topic>Complications</topic><topic>Dissection</topic><topic>Hospitals</topic><topic>Infections</topic><topic>Laparoscopy</topic><topic>Lung cancer</topic><topic>Lung cancer, Non-small cell</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Medical prognosis</topic><topic>Mortality</topic><topic>Non-small cell lung carcinoma</topic><topic>Normal distribution</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>Postoperative</topic><topic>Robotic surgery</topic><topic>Robotics</topic><topic>Robots</topic><topic>Small cell lung carcinoma</topic><topic>Thoracic surgery</topic><topic>Thorax</topic><topic>Tomography</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ureña, Anna</creatorcontrib><creatorcontrib>Moreno, Camilo</creatorcontrib><creatorcontrib>Macia, Ivan</creatorcontrib><creatorcontrib>Rivas, Francisco</creatorcontrib><creatorcontrib>Déniz, Carlos</creatorcontrib><creatorcontrib>Muñoz, Anna</creatorcontrib><creatorcontrib>Serratosa, Ines</creatorcontrib><creatorcontrib>García, Marta</creatorcontrib><creatorcontrib>Masuet-Aumatell, Cristina</creatorcontrib><creatorcontrib>Escobar, Ignacio</creatorcontrib><creatorcontrib>Ramos, Ricard</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</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>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ureña, Anna</au><au>Moreno, Camilo</au><au>Macia, Ivan</au><au>Rivas, Francisco</au><au>Déniz, Carlos</au><au>Muñoz, Anna</au><au>Serratosa, Ines</au><au>García, Marta</au><au>Masuet-Aumatell, Cristina</au><au>Escobar, Ignacio</au><au>Ramos, Ricard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Comparison of Total Thoracoscopic and Robotic Surgery for Lung Cancer Lymphadenectomy</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2023-06-30</date><risdate>2023</risdate><volume>15</volume><issue>13</issue><spage>3442</spage><pages>3442-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>Robotic-assisted thoracic surgery (RATS) is used increasingly frequently in major lung resection for early stage non-small-cell lung cancer (NSCLC) but has not yet been fully evaluated. The aim of this study was to compare the surgical outcomes of lymph node dissection (LND) performed via RATS with those from totally thoracoscopic (TT) four-port videothoracoscopy.
Clinical and pathological data were collected retrospectively from patients with clinical stage N0 NSCLC who underwent pulmonary resection in the form of lobectomy or segmental resection between June 2010 and November 2022. The assessment criteria were number of mediastinal lymph nodes and number of mediastinal stations dissected via the RATS approach compared with the four-port TT approach.
A total of 246 pulmonary resections with LND for clinical stages I-II NSCLC were performed: 85 via TT and 161 via RATS. The clinical characteristics of the patients were similar in both groups. The number of mediastinal nodes dissected and mediastinal stations dissected was significantly higher in the RATS group (TT: mean ± SD, 10.72 ± 3.7; RATS, 14.74 ± 6.3 [
< 0.001]), except in the inferior mediastinal stations. There was no difference in terms of postoperative complications.
In patients with early stage NSCLC undergoing major lung resection, the quality of hilomediastinal LND performed using RATS was superior to that performed using TT.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37444555</pmid><doi>10.3390/cancers15133442</doi><orcidid>https://orcid.org/0000-0001-5557-9812</orcidid><orcidid>https://orcid.org/0000-0001-7000-7345</orcidid><orcidid>https://orcid.org/0009-0005-8632-830X</orcidid><orcidid>https://orcid.org/0000-0002-5718-8900</orcidid><orcidid>https://orcid.org/0000-0002-3789-2052</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2072-6694 |
| ispartof | Cancers, 2023-06, Vol.15 (13), p.3442 |
| issn | 2072-6694 2072-6694 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10341346 |
| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Cancer surgery Cardiac arrhythmia Chronic obstructive pulmonary disease Comparative analysis Complications Dissection Hospitals Infections Laparoscopy Lung cancer Lung cancer, Non-small cell Lymph nodes Lymphatic system Medical prognosis Mortality Non-small cell lung carcinoma Normal distribution Patients Pneumonia Postoperative Robotic surgery Robotics Robots Small cell lung carcinoma Thoracic surgery Thorax Tomography Tumors |
| title | A Comparison of Total Thoracoscopic and Robotic Surgery for Lung Cancer Lymphadenectomy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-13T06%3A29%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Comparison%20of%20Total%20Thoracoscopic%20and%20Robotic%20Surgery%20for%20Lung%20Cancer%20Lymphadenectomy&rft.jtitle=Cancers&rft.au=Ure%C3%B1a,%20Anna&rft.date=2023-06-30&rft.volume=15&rft.issue=13&rft.spage=3442&rft.pages=3442-&rft.issn=2072-6694&rft.eissn=2072-6694&rft_id=info:doi/10.3390/cancers15133442&rft_dat=%3Cgale_pubme%3EA757714486%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2836340215&rft_id=info:pmid/37444555&rft_galeid=A757714486&rfr_iscdi=true |