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Article ; Online: Predicting Response to Anthracyclines in Ovarian Cancer.

Ferrero, Annamaria / Borghese, Martina / Restaino, Stefano / Puppo, Andrea / Vizzielli, Giuseppe / Biglia, Nicoletta

International journal of environmental research and public health

2022 Volume 19, Issue 7

Abstract: 1) Background: Anthracyclines are intriguing drugs, representing one of the cornerstones of both first and subsequent-lines of chemotherapy in ovarian cancer (OC). Their efficacy and mechanisms of action are related to the hot topics of OC clinical ... ...

Abstract	(1) Background: Anthracyclines are intriguing drugs, representing one of the cornerstones of both first and subsequent-lines of chemotherapy in ovarian cancer (OC). Their efficacy and mechanisms of action are related to the hot topics of OC clinical research, such as BRCA status and immunotherapy. Prediction of response to anthracyclines is challenging and no markers can predict certain therapeutic success. The current narrative review provides a summary of the clinical and biological mechanisms involved in the response to anthracyclines. (2) Methods: A MEDLINE search of the literature was performed, focusing on papers published in the last two decades. (3) Results and Conclusions: BRCA mutated tumors seem to show a higher response to anthracyclines compared to sporadic tumors and the severity of hand-foot syndrome and mucositis may be a predictive marker of PLD efficacy. CA125 can be a misleading marker of clinical response during treatment with anthracyclines, the response of which also appears to depend on OC histology. Immunochemistry, in particular HER-2 expression, could be of some help in predicting the response to such drugs, and high levels of mutated p53 appear after exposure to anthracyclines and impair their antitumor effect. Finally, organoids from OC are promising for drug testing and prediction of response to chemotherapy.
MeSH term(s)	Anthracyclines/therapeutic use ; Antibiotics, Antineoplastic/pharmacology ; Antibiotics, Antineoplastic/therapeutic use ; Carcinoma, Ovarian Epithelial/drug therapy ; Doxorubicin/pharmacology ; Doxorubicin/therapeutic use ; Humans ; Ovarian Neoplasms/drug therapy ; Polyethylene Glycols/pharmacology
Chemical Substances	Anthracyclines ; Antibiotics, Antineoplastic ; Polyethylene Glycols (3WJQ0SDW1A) ; Doxorubicin (80168379AG)
Language	English
Publishing date	2022-04-02
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19074260
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Article ; Online: Implementing Enhanced Recovery After Surgery for hysterectomy in a hospital network with audit and feedback: A stepped-wedge cluster randomised trial.

Piovano, Elisa / Puppo, Andrea / Camanni, Marco / Castiglione, Anna / Delpiano, Elena Maria / Giacometti, Lisa / Rolfo, Monica / Rizzo, Alessio / Zola, Paolo / Ciccone, Giovannino / Pagano, Eva

BJOG : an international journal of obstetrics and gynaecology

2024

Abstract: Objective: To evaluate the effectiveness of implementing the Enhanced Recovery After Surgery (ERAS) protocol in patients undergoing elective hysterectomy in a network of regional hospitals, supported by an intensive audit-and-feedback (A&F) approach.: ...

Abstract	Objective: To evaluate the effectiveness of implementing the Enhanced Recovery After Surgery (ERAS) protocol in patients undergoing elective hysterectomy in a network of regional hospitals, supported by an intensive audit-and-feedback (A&F) approach. Design: A multi-centre, stepped-wedge cluster randomised trial (ClinicalTrials.gov NCT04063072). Setting: Gynaecological units in the Piemonte region, Italy. Population: Patients undergoing elective hysterectomy, either for cancer or for benign conditions. Methods: Twenty-three units (clusters), stratified by surgical volume, were randomised into four sequences. At baseline (first 3 months), standard care was continued in all units. Subsequently, the four sequences implemented the ERAS protocol successively every 3 months, after specific training. By the end of the study, each unit had a period in which standard care was maintained (control) and a period in which the protocol, supported by feedback, was applied (experimental). Main outcome measures: Length of hospital stay (LOS), without outliers (>98th percentile). Results: Between September 2019 and May 2021, 2086 patients were included in the main analysis with an intention-to-treat approach: 1104 (53%) in the control period and 982 (47%) in the ERAS period. Compliance with the ERAS protocol increased from 60% in the control period to 76% in the experimental period, with an adjusted absolute difference of +13.3% (95% CI 11.6% to 15.0%). LOS, moving from 3.5 to 3.2 days, did not show a significant reduction (-0.12 days; 95% CI -0.30 to 0.07 days). No difference was observed in the occurrence of complications. Conclusions: Implementation of the ERAS protocol for hysterectomy at the regional level, supported by an A&F approach, resulted in a substantial improvement in compliance, but without meaningful effects on LOS and complications. This study confirms the effectiveness of A&F in promoting important innovations in an entire hospital network and suggests the need of a higher compliance with the ERAS protocol to obtain valuable improvements in clinical outcomes.
Language	English
Publishing date	2024-02-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.17797
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Article ; Online: Traditional McCall culdoplasty compared to a modified McCall technique with double ligament suspension: anatomical and clinical outcomes.

Parisi, Silvia / Novelli, Antonia / Olearo, Elena / Basile, Alessandro / Puppo, Andrea

International urogynecology journal

2020 Volume 31, Issue 10, Page(s) 2147–2153

Abstract: Introduction and hypothesis: This study compared anatomical and clinical outcomes of traditional McCall culdoplasty versus a modified McCall technique with double ligament suspension (DLS).: Methods: This retrospective study presents outcomes of 68 ... ...

Abstract	Introduction and hypothesis: This study compared anatomical and clinical outcomes of traditional McCall culdoplasty versus a modified McCall technique with double ligament suspension (DLS). Methods: This retrospective study presents outcomes of 68 patients who underwent vaginal hysterectomy and vaginal suspension for apical prolapse ≥ stage II according to the POP-Q score system, at, between January 2016 and February 2018. In 34 women vaginal cuff suspension was obtained with traditional McCall culdoplasty (McCall group), while in 34 women we performed a modified McCall, which consists of a double ligament suspension (DLS group), suspending the vaginal cuff to uterosacral ligaments and also to adnexal peduncles. Primary outcome was prolapse recurrence ≥ stage II according to the POP-Q system. Fisher's, Mann-Whitney U and Student's t tests were used for statistical analysis. Results: There were no statistical differences among patients' preoperative characteristics, operative time, blood loss or postoperative complications. Follow-up mean duration was 23.2 ± 6.7 and 22.4 ± 8.7 months in the McCall and DLS group, respectively. Prolapse recurrence occurred in 11 (32.3%) women in the McCall group versus 2 (5.9%) women in the DLS group (p < 0.05): among them, 2 patients (5.9%) in the McCall group and 1 (2.9%) in the DLS group required further treatment. Total vaginal length was 6.1 ± 0.9 cm in the McCall group versus 6.9 ± 0.7 cm in the DLS group (p < 0.001). No statistical difference in quality of life assessment was observed. Conclusions: DLS group patients had better anatomical outcomes and lower recurrence rates than McCall group patients, without increasing operative time or complications. A prospective study with more cases is needed to confirm our data.
MeSH term(s)	Female ; Humans ; Hysterectomy, Vaginal ; Ligaments/surgery ; Pelvic Organ Prolapse/surgery ; Prospective Studies ; Quality of Life ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2020-06-27
Publishing country	England
Document type	Journal Article
ZDB-ID	1050631-7
ISSN	1433-3023 ; 0937-3462
ISSN (online)	1433-3023
ISSN	0937-3462
DOI	10.1007/s00192-020-04403-4
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Article ; Online: Vacuum delivery in all-fours position: is it a valuable, brand-new option?

Masturzo, Bianca / Delogu, Giuseppe / Germano, Chiara / Ghi, Tullio / Rizzo, Giuseppe / Puppo, Andrea / Attini, Rossella / Revelli, Alberto / Manzoni, Paolo

American journal of obstetrics & gynecology MFM

2022 Volume 4, Issue 6, Page(s) 100691

Abstract: Since all-fours birth position is considered to decrease the rate of failure of vaginal birth and the risk of negative maternal and fetal outcomes, we wondered if all-fours would be favorable in case of operative vaginal delivery with obstetrical vacuum. ...

Abstract	Since all-fours birth position is considered to decrease the rate of failure of vaginal birth and the risk of negative maternal and fetal outcomes, we wondered if all-fours would be favorable in case of operative vaginal delivery with obstetrical vacuum. We performed a simulation of vacuum application on a mannequin settled in all-fours position and we filmed this new application for diffusion among clinicians. We suggest that the all-fours position be considered and investigated in further studies as a possible way of delivery in case of operative vaginal delivery.
Language	English
Publishing date	2022-07-16
Publishing country	United States
Document type	Video-Audio Media
ISSN	2589-9333
ISSN (online)	2589-9333
DOI	10.1016/j.ajogmf.2022.100691
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Article ; Online: Successful laparoscopic surgical removal of a caesarean scar pregnancy (CSP) using temporary uterine artery ligation.

Calandra, Valerio / Bonino, Luca / Olearo, Elena / Musizzano, Yuri / Orcioni, Giulio Fraternali / Franchi, Massimo Piergiuseppe / Uccella, Stefano / Puppo, Andrea

Journal of minimally invasive gynecology

2022 Volume 29, Issue 12, Page(s) 1292–1293

Abstract: Study objective: To demonstrate a laparoscopic technique to remove a scar pregnancy.: Design: Stepwise demonstration of the surgical technique.: Setting: Santa Croce and Carle Hospital, Cuneo.: Intervention: Patient B.B. is a woman referred to ... ...

Abstract	Study objective: To demonstrate a laparoscopic technique to remove a scar pregnancy. Design: Stepwise demonstration of the surgical technique. Setting: Santa Croce and Carle Hospital, Cuneo. Intervention: Patient B.B. is a woman referred to our center for a suspected cesarean scar pregnancy (CSP) at 9 weeks gestation. CSP occurs approximately in 6% of all ectopic pregnancies. The estimated incidence is reported to be 1:1800 to 1:2500 in cesarean deliveries. Depending on its location, CSP can be categorized as either type 1, if the growth is in the uterine cavity, or type 2, if it expands toward the bladder and the abdominal cavity. If inadequately managed, it can lead to severe complications; most of them are hemorrhagic and can threaten the woman's life. There are several therapeutic approaches: local excision seems to be the most effective choice in type 2 CSP. In expert hands, the laparoscopic approach is perhaps the best surgical choice as tissue dissection, electrosurgical hemostasis, and vascular control can be effectively managed with minimal invasive access. Because severe intraoperative bleeding can occur, retroperitoneal vascular control is mandatory in this surgery. In type 1 CSP curettage, aspiration or hysteroscopic approach can be considered if the CSP is of small dimensions. A hysteroscopic approach can also be helpful in type 2 CSP during the laparoscopic removal, as intrauterine guidance. A potassium chloride local injection can be considered in a preoperative stage in the presence of a fetal heart rate. The systemic administration of methotrexate is usually ineffective as single agent, but it can be useful if administered as adjuvant therapy. Uterine artery embolization can be useful in an emergency setting to manage severe bleeding, but it can lead to complications in subsequent pregnancies and, more rarely, to premature ovarian failure. Considering poor bleeding at presentation, feasible dimensions, and the woman's desire for future pregnancy, ultrasound-guided aspiration and curettage was attempted. Because endouterine removal was incomplete, methotrexate injection was proposed as adjuvant therapy, but the administration was postponed as the patient tested positive for coronavirus disease 2019. A month later, beta-human chorionic gonadotropin level dropped from over 16 000 to 271 mU/mL, so an ultrasound and biochemical follow-up was performed. A month later, despite a low beta-human chorionic gonadotropin value, an increase in dimensions was observed at ultrasound, so surgical laparoscopic removal was offered. In this video article, laparoscopic removal of scar pregnancy is discussed in the following surgical steps: (1) Temporary closure of uterine arteries at the origin, using removable clips. (2) Retroperitoneal dissection to safely manage the scar pregnancy. (3) Dissection of the myometrial-pregnancy interface. (4) Double layer suture on the anterior uterine wall. Conclusion: Laparoscopic surgical management is a very effective surgical approach to remove CSP. Knowledge of retroperitoneal dissection and vascular control is necessary to carry out this surgical intervention safely and effectively.
Language	English
Publishing date	2022-09-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2186934-0
ISSN	1553-4669 ; 1553-4650
ISSN (online)	1553-4669
ISSN	1553-4650
DOI	10.1016/j.jmig.2022.09.011
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Article ; Online: Application of failure mode and effect analysis in total laparoscopic hysterectomy in benign conditions.

Lijoi, Davide / Farina, Massimo / Puppo, Andrea / Novelli, Antonia / Ferrero, Simone

Minerva ginecologica

2019 Volume 71, Issue 4, Page(s) 272–280

Abstract: Background: Hysterectomy is the most common major gynecological operation in developed countries. The rate of intraoperative complications related to the laparoscopic approach during hysterectomy is a relevant issue. The failure mode and effect analysis ...

Abstract	Background: Hysterectomy is the most common major gynecological operation in developed countries. The rate of intraoperative complications related to the laparoscopic approach during hysterectomy is a relevant issue. The failure mode and effect analysis (FMEA) method is a prospective approach, which tries to identify possible errors before they occur. Methods: In this study we applied the FMEA method to laparoscopic approach to hysterectomy in order to reduce the theorized risk of intraoperative complications. We selected a team who analyzed and deconstructed the total laparoscopic hysterectomy (TLH) process recording on the FMEA worksheet phases and activities of the entire procedure. Each activity-related failure mode and their potential effects were developed. The team also described actions to eliminate or decrease the likelihood of mistakes. Results: A numerical value reflecting the risk was assigned to each activity. Five activities were identified as high priority risk, and for each activity actions were then taken to mitigate the identified risk. After introduction of these actions, the risk scores for each activity were recalculated, and we obtained a total risk reduction of 55%. Conclusions: It is our opinion that the systematic implementation of the FMEA model can reduce the risk of human error during laparoscopic surgery, improving patient safety.
MeSH term(s)	Female ; Genital Diseases, Female/surgery ; Healthcare Failure Mode and Effect Analysis ; Humans ; Hysterectomy/methods ; Intraoperative Complications/epidemiology ; Laparoscopy/methods ; Medical Errors/prevention & control ; Patient Safety ; Risk Assessment/methods ; Risk Management/methods
Language	English
Publishing date	2019-03-29
Publishing country	Italy
Document type	Journal Article
ZDB-ID	80159-8
ISSN	1827-1650 ; 0026-4784 ; 0325-8793
ISSN (online)	1827-1650
ISSN	0026-4784 ; 0325-8793
DOI	10.23736/S0026-4784.19.04227-8
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Article ; Online: SUrgical Access and Pattern of Recurrence of Endometrial Cancer: The SUPeR Study, a Multicenter Retrospective Observational Study.

Puppo, Andrea / Migliaretti, Giuseppe / Landoni, Fabio / Uccella, Stefano / Camanni, Marco / Ceccaroni, Marcello / Delpiano, Elena M / Mantovani, Giulia / Roviglione, Giovanni / Bianchi, Tommaso / Grassi, Tommaso / Maggi, Veronica / Garzon, Simone / Galli, Liliana / Calandra, Valerio / Olearo, Elena

Journal of minimally invasive gynecology

2024 Volume 31, Issue 4, Page(s) 321–329

Abstract: Study objective: To evaluate recurrence rate and pattern in apparently early-stage endometrial cancer (EC) treated with minimally invasive surgery (MIS) and compare it to the "historical" populations treated by laparotomy. Secondary outcomes were to ... ...

Abstract	Study objective: To evaluate recurrence rate and pattern in apparently early-stage endometrial cancer (EC) treated with minimally invasive surgery (MIS) and compare it to the "historical" populations treated by laparotomy. Secondary outcomes were to establish if, among MIS recurrent patients, intermediate-high/high-risk patients presented the same recurrence pattern compared to those at low/intermediate-risk and to evaluate time to first recurrence (TTR) of the study population. Design: Multicenter retrospective observational study. Setting: Five Italian Gynecologic Oncology referral centers. Patients: All patients with proven recurrence of apparently early-stage EC treated with MIS from January 2017 to June 2022 . The laparotomic historical cohort was obtained from Laparoscopy Compared With Laparotomy for Comprehensive Surgical Staging of Uterine Cancer: Gynecologic Oncology Group Study (LAP2) and Laparoscopic Approach to Cancer of the Endometrium trials. Interventions: Evaluation of recurrence rate and pattern. Measurements and main results: Seventy-seven recurrences occurred on the total of 1028 patients treated with MIS for apparently early-stage EC during a median follow-up time of 36 months. The rate of recurrence in our cohort did not differ significantly from the rate of the historical cohort (7.4% vs 7.9%, odds ratio 0.9395, 95% CI 0.6901-1.2792). No significant differences were noticed for local, abdominal, nodal, and multiple site recurrence patterns; distant site recurrence appeared more likely in patients from the historical cohort. Postoperative low/intermediate risk patients had a higher likelihood of local recurrence compared to intermediate-high/high risk patients. Mean TTR was 19 months. No significant difference of TTR was observed for each pattern of recurrence compared to others. Conclusion: MIS appears to be safe for the treatment of early-stage EC. We did not identify any recurrence pattern specifically associated with MIS in early-stage EC.
MeSH term(s)	Humans ; Female ; Endometrial Neoplasms/surgery ; Endometrial Neoplasms/pathology ; Retrospective Studies ; Hysterectomy ; Laparotomy/adverse effects ; Laparoscopy/adverse effects ; Minimally Invasive Surgical Procedures ; Neoplasm Staging ; Neoplasm Recurrence, Local/surgery
Language	English
Publishing date	2024-02-01
Publishing country	United States
Document type	Observational Study ; Multicenter Study ; Journal Article
ZDB-ID	2186934-0
ISSN	1553-4669 ; 1553-4650
ISSN (online)	1553-4669
ISSN	1553-4650
DOI	10.1016/j.jmig.2024.01.016
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Article ; Online: Intraoperative Ultrasound for Bowel Deep Infiltrating Endometriosis: A Preliminary Report.

Puppo, Andrea / Olearo, Elena / Gattolin, Andrea / Rimonda, Roberto / Novelli, Antonia / Ceccaroni, Marcello

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

2020 Volume 40, Issue 7, Page(s) 1417–1425

Abstract: The decision to perform either conservative surgery or segmental bowel resection for bowel deep infiltrating endometriosis (DIE) is made intraoperatively, after a preoperative assessment, based on the nodule's features. We introduce a technique to ... ...

Abstract	The decision to perform either conservative surgery or segmental bowel resection for bowel deep infiltrating endometriosis (DIE) is made intraoperatively, after a preoperative assessment, based on the nodule's features. We introduce a technique to evaluate DIE bowel nodules using laparoscopic intraoperative ultrasound (US) during laparoscopic radical treatment of 9 cases of DIE invading the bowel. Once the bowel lesion was isolated, an intraoperative 12-4-MHz US transducer was placed on the surface of the nodules to study their US features and to gain measurements. Deep infiltrating endometriosis nodules appear at intraoperative US as hypoechoic elliptical lesions with a clear definition of margins and the depth of infiltration of the rectal wall.
MeSH term(s)	Digestive System Surgical Procedures ; Endometriosis/diagnostic imaging ; Endometriosis/surgery ; Female ; Humans ; Laparoscopy ; Rectal Diseases ; Rectum ; Ultrasonography
Language	English
Publishing date	2020-09-29
Publishing country	England
Document type	Journal Article
ZDB-ID	604829-8
ISSN	1550-9613 ; 0278-4297
ISSN (online)	1550-9613
ISSN	0278-4297
DOI	10.1002/jum.15511
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Article: Factor structure of post-operative quality of recovery questionnaire (QoR-15): An Italian adaptation and validation.

Rosato, Rosalba / Palazzo, Valentina / Borghi, Felice / Camanni, Marco / Puppo, Andrea / Delpiano, Elena Maria / Pellegrino, Luca / Piovano, Elisa / Rizzo, Alessio / Rolfo, Monica / Morino, Mario / Allaix, Marco Ettore / Testa, Silvia / Ciccone, Giovannino / Pagano, Eva

Frontiers in psychology

2023 Volume 13, Page(s) 1096579

Abstract: Background: The Quality of Recovery questionnaire (QoR-15) is an English instrument for measuring quality of recovery in surgical patients, not yet translated and validated in Italian when the Enhanced Recovery After Surgery (ERAS) Piemonte studies were ...

Abstract	Background: The Quality of Recovery questionnaire (QoR-15) is an English instrument for measuring quality of recovery in surgical patients, not yet translated and validated in Italian when the Enhanced Recovery After Surgery (ERAS) Piemonte studies were planned. Objective: To produce the Italian version of the QoR-15 questionnaire, to evaluate its factorial structure and to assess the invariance between two types of surgery. Methods: The Italian version (QoR-15I) was obtained translating and adapting the original version to the Italian context. The validation was performed suppling the QoR-15I to 3,784 patients enrolled in two parallel stepped wedge cluster randomised trials (ERAS Colon-rectum Piemonte; ERAS Gyneco Piemonte). The factor structure and its invariance between types of surgery was tested using confirmatory bifactor model and multi-group analysis. Comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR) fit indices and their changes between nested models were used to assess the factor structure and the invariance. Results: The bifactor model showed good fit (RMSEA = 0.049, CFI =0.957, SRMR = 0.036) and provided a general recovery factor and two specific factors for physical and mental recovery. Eighty-four percent of the common variance is attributable to the general factor, and thus the QoR-15I is sufficiently 'one-dimensional' with an adequate reliability (ω Conclusion: Our results support the use of the QoR-15I as a valid, reliable, and clinically feasible tool for measuring the quality of recovery after surgery. The results of the confirmatory factor analyses suggest that a unique recovery score can be calculated and support measurement invariance of the QOR-15I across the two type of surgery, suggesting that the questionnaire has the same meaning and the same measurement parameters in colorectal and gynaecologic patients.
Language	English
Publishing date	2023-02-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2563826-9
ISSN	1664-1078
ISSN	1664-1078
DOI	10.3389/fpsyg.2022.1096579
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Article: Low-Pressure Laparoscopy Using the AirSeal System versus Standard Insufflation in Early-Stage Endometrial Cancer: A Multicenter, Retrospective Study (ARIEL Study).

Buda, Alessandro / Di Martino, Giampaolo / Borghese, Martina / Restaino, Stefano / Surace, Alessandra / Puppo, Andrea / Paracchini, Sara / Ferrari, Debora / Perotto, Stefania / Novelli, Antonia / De Ponti, Elena / Borghi, Chiara / Fanfani, Francesco / Fruscio, Robert

Healthcare (Basel, Switzerland)

2022 Volume 10, Issue 3

Abstract: The aim of our study was to evaluate the benefits of a low-pressure insufflation system (AirSeal) vs. a standard insufflation system in terms of anesthesiologists’ parameters and postoperative pain in patients undergoing laparoscopic surgery for early- ... ...

Abstract	The aim of our study was to evaluate the benefits of a low-pressure insufflation system (AirSeal) vs. a standard insufflation system in terms of anesthesiologists’ parameters and postoperative pain in patients undergoing laparoscopic surgery for early-stage endometrial cancer. This retrospective study involved five tertiary centers and included 152 patients with apparent early-stage disease who underwent laparoscopic surgical staging with either the low-pressure AirSeal system (8−10 mmHg, n = 84) or standard laparoscopic insufflation (10−12 mmHg, n = 68). All the intraoperative anesthesia variables evaluated (systolic blood pressure, end-tidal CO2, peak airway pressure) were significantly lower in the AirSeal group. We recorded a statistically significant difference between the two groups in the median NRS scores for global pain recorded at 4, 8, and 24 h, and for overall shoulder pain after surgery. Significantly more women in the AirSeal group were also discharged on day one compared to the standard group. All such results were confirmed when analyzing the subgroup of women with a BMI >30 kg/m2. In conclusion, according to our preliminary study, low-pressure laparoscopy represents a valid alternative to standard laparoscopy and could facilitate the development of outpatient surgery.
Language	English
Publishing date	2022-03-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare10030531
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