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Urology 2020 May 29. Epub 2020 May 29.

Department of Pediatric Surgery and Urology, School of Medicine in Katowice, Medical University of Silesia in Katowice, ul. Medyków 16, 40-752 Katowice, Poland.

Aggressive angiomyxoma (AAM) is a rare tumor with a high risk of local recurrence. Scrotal AAM mimics common pediatric pathologies including hernia or hydrocele. We present 11-year-old boy who underwent macroscopically radical excision of right scrotal AAM. Read More

Urol J 2020 May 27;0(0):5685. Epub 2020 May 27.

Department of Pediatric Endocrinology, Ospedale Pediatrico Bambino Gesù, Rome, Italy.

Persistent müllerian duct syndrome (PMDS) in the majority of cases is discovered during surgery for inguinal hernia or cryptorchidism. A transverse testicular ectopia (TTE) with cryptorchidism may be very rarely associated to PMDS. Assuming that müllerian remnants have a very low malignant degeneration potential if compared to the malignancy risk of an undescended and not relocated testis, we describe a simplified surgical technique of orchiopexy that avoids an extensive anatomical dissection, in this way minimizing the risk of losing the deferential blood supply to the testis. Read More

Clin Case Rep 2020 May 26;8(5):855-857. Epub 2020 Feb 26.

Emergency and Critical Care Center Kurashiki Central Hospital Kurashiki Okayama Japan.

Diseases of the uterus and adnexa uteri should be considered when evaluating female patients with lower abdominal pain. Diseases caused by defects in the supporting ligaments of the female reproductive system should also be considered. Read More

Ann Med Surg (Lond) 2020 Jul 18;55:143-147. Epub 2020 May 18.

Sunderland Bariatric Unit, Sunderland Royal Hospital, Sunderland, United Kingdom.

Introduction: Most Bariatric units perform Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) and One Anastomosis Gastric Bypass (OAGB) for weight loss and metabolic purposes with satisfactory results and low complication profile.

Objectives: This study compares LRYGB and OAGB outcomes in a high volume single bariatric unit.

Methods: Data was collected prospectively and analysed retrospectively for all LRYGB and OAGB performed between Jan 2014 to Dec 2016. Read More

Ann Med Surg (Lond) 2020 Jul 16;55:93-96. Epub 2020 May 16.

Department of Surgery, Aleppo University Hospital, University of Aleppo, Syria.

Peripheral Primitive NeuroEctodermal Tumors (pPNETs) are rare highly malignant tumors; originating from the neuroectoderm. Although PNETs may arise in various locations (most commonly in the extremities), very few cases have been reported in the pelvis. There is still poor evidence about the management of these tumors in the literature. Read More

J Can Chiropr Assoc 2020 Apr;64(1):88-91

Private practice.

Objectives: To present a case of a tibialis anterior muscle herniation in a soccer player.

Clinical Features: A 28-year-old male soccer player presented with a trauma-induced injury to his right anterior shin. After assessment and due to his clinical signs and symptoms, a high suspicion of tibialis anterior muscle herniation was suspected. Read More

Dis Esophagus 2020 Jun 1. Epub 2020 Jun 1.

Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Germany.

Laparoscopic fundoplication is considered the gold standard surgical procedure for the treatment of symptomatic hiatus hernia. Studies on surgical performance in minimally invasive hiatus hernia repair have neglected the role of the camera assistant so far. The current study was designed to assess the applicability of the structured assessment of laparoscopic assistance skills (SALAS) score to laparoscopic fundoplication as an advanced and commonly performed laparoscopic upper GI procedure. Read More

Dis Esophagus 2020 Jun 1. Epub 2020 Jun 1.

Division of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Despite paraesophageal hernias (PEH) being a common disorder, several aspects of their management remain elusive. Elective surgery in asymptomatic patients, management of acute presentation, and other technical aspects such as utilization of mesh, fundoplication or gastropexy are some of the debated issues. The aim of this study was to review the available evidence in an attempt to clarify current controversial topics. Read More

J Plast Reconstr Aesthet Surg 2020 May 18. Epub 2020 May 18.

Department of Plastic Surgery, China Medical University and China Medical University Hospital, 2, Yuh-Der Road, Taichung 40447, Taiwan. Electronic address:

Laparoscopic harvest method to obtain gastro-epiploic lymph node flaps for lymphedema treatment has been previously described. In this article, the technical details of an alternative method - open approach via mini-laparotomy incision - for harvesting gastro-epiploic lymph node flaps and preparation of the flaps for the inset is presented. A total of 17 patients were included in this series of the mini-laparotomy approach. Read More

Asian J Surg 2020 May 28. Epub 2020 May 28.

Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wrocław, Poland. Electronic address:

Asian J Surg 2020 May 29. Epub 2020 May 29.

Arcispedale Santa Maria Nuova AUSL-IRCCS, Reggio Emilia Viale Risorgimento, 80 41122, Reggio Emilia, Italy.

J Pediatr Surg 2020 May 3. Epub 2020 May 3.

Cincinnati Children's Hospital Medical Center, Division of Pediatric General and Thoracic Surgery, Cincinnati, OH, USA.

Background/purpose: Morbidity and mortality in the giant omphalocele population is complicated by large abdominal wall defects, physiologic aberrancies, and congenital anomalies. We hypothesized different anomalies and treatment types would affect outcomes.

Methods: A 2009-2018 retrospective chart review of giant omphaloceles was performed. Read More

Stem Cells Dev 2020 May 30. Epub 2020 May 30.

University of Texas McGovern Medical School, 12339, Pediatric Surgery, Houston, Texas, United States;

Congenital diaphragmatic hernia (CDH) leads to pathophysiologic pulmonary vasoreactivity. Previous studies show that mesenchymal stromal cell-derived extracellular vesicles (MSCEv) inhibit lung inflammation and vascular remodeling. We characterize MSCEv and human pulmonary artery endothelial cell (HPAEC) interaction as well as the pulmonary artery (PA) response to MSCEv treatment. Read More

Hernia 2020 May 30. Epub 2020 May 30.

Netherlands Center for Occupational Diseases, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands.

Purpose: Clinicians need to know whether inguinal hernia (IH) can be attributed to work to answer questions regarding prevention and medical causation. This review describes whether work-related risk factors are associated with IH.

Methods: A systematic review was performed in Medline via PubMed until February 3rd, 2020. Read More

Hernia 2020 May 30. Epub 2020 May 30.

Universidade Tiradentes, Bloco E, sala 40. Avenida Murilo Dantas, nº 300, Bairro Farolândia, Aracaju, Sergipe, CEP: 49032-490, Brazil.

Eur J Med Genet 2020 May 27:103955. Epub 2020 May 27.

Laboratory of Human Genetics and Mutagenesis, Institute of Biology, Federal University of Bahia, Salvador, Bahia, Brazil. Electronic address:

Prader-Willi syndrome (PWS) is one of the common neurogenetic disorders associated with intellectual disability. PWS involves a complex inheritance pattern and is caused by an absence of gene expression on the paternally inherited 15q11.2-q13 region, either due to deletion, maternal uniparental disomy or imprinting defect. Read More

Hernia 2020 May 29. Epub 2020 May 29.

Department of General Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.

Background: Acute IH is a common surgical presentation. Despite new guidelines being published recently, a number of important questions remained unanswered including the role of taxis, as initial non-operative management. This is particularly relevant now due to the possibility of a lack of immediate surgical care as a result of COVID-19. Read More

Urologe A 2020 May 29. Epub 2020 May 29.

Klinik für Kinderchirurgie und Kinderurologie, Kinderkrankenhaus Amsterdamer Straße, Amsterdamer Straße 59, 50735, Köln, Deutschland.

Aphallia is an extremely rare congenital malformation of unknown cause. The incidence is reported in the literature to be 1 in 10-30 million live births. Almost 100 cases have been described to date. Read More

Surg Radiol Anat 2020 May 29. Epub 2020 May 29.

Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.

Orbital fat herniation is primarily in a subconjunctival location. However, herniation through the inferior orbital fissure (IOF) has been scantly reported. Here, we report a cadaveric case of herniation of orbital fat through the inferior orbital fissure and into the infratemporal fossa. Read More

Colorectal Dis 2020 May 29. Epub 2020 May 29.

Colorectal Surgery Unit, University Hospital Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.

Robotic right hemicolectomy has been associated with several advantages compared with laparoscopic colectomy, including lower anastomotic complications, increased lymph node harvest, reduced length of stay, and reduced conversion to open surgery rates. Robotic surgery eases suturing and enables reinforcement of the stapled anastomosis facilitating intracorporeal anastomoses. The latter have been associated with reduced incidence of hernia rates and faster recovery. Read More

Arch Argent Pediatr 2020 Jun;118(3):180-186

Departamento de Pediatría, Servicio de Neonatología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.

Introduction: Morbidity and mortality are high in congenital diaphragmatic hernia. Some tools help to predict survival, both prenatally (observed/expected lung-to-head ratio [OELHR], presence of the liver in the chest) and postnatally (Congenital Diaphragmatic Hernia Study Group [CDHSG] score). Our objective was to identify the risk factors associated with mortality and estimate the risk-adjusted mortality in the prenatal period in the subgroup of patients with isolated left-sided hernia. Read More

Arch Argent Pediatr 2020 Jun;118(3):173-179

Área de Terapia Intensiva Neonatal, Hospital de Pediatría SAMIC "Prof. Dr. Juan. P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.

Introduction: Congenital diaphragmatic hernia (CDH) prevalence is low while its associated morbidity and mortality rates are high. Postnatal prognostic factors on the first day of life are useful for predicting the outcome.

Objectives: To determine the mortality predictive ability of postnatal echocardiographic, clinical, and biochemical factors among newborn infants with CDH in their first day of life. Read More

Ortop Traumatol Rehabil 2020 Apr;22(2):107-119

Katedra i Zakład Farmakologii Doświadczalnej i Klinicznej, Warszawski Uniwersytet Medyczny, Warszawa, Polska.

Background: Osteoarthritis is a global health problem. Approaches to symptomatic treatment of its consequences in-clude biological methods, including autologous serum. The aim of the study was to evaluate the effectiveness of Orthokine therapy in our experience. Read More

Asian J Endosc Surg 2020 May 28. Epub 2020 May 28.

Department of Surgery, Nara Medical University, Kashihara, Japan.

Introduction: Laparoscopic inguinal hernia repair is reported to be associated with lower postoperative pain than open repair. However, in the actual clinical setting, some patients experience relatively severe pain. This study aimed to elucidate surgical factors that affect pain after transabdominal preperitoneal (TAPP) repair. Read More

Surg Endosc 2020 May 28. Epub 2020 May 28.

Department of Gastroenterological Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-Ku, Osaka City, Osaka, 543-0035, Japan.

Background: Small bowel obstruction (SBO) arises on various backgrounds, and the surgical procedure is often modified intraoperatively as needed. Single-incision laparoscopic surgery (SILS) is less invasive than conventional multiport laparoscopic surgery (MPS) and reported to be equally safe and efficient. We have been applying SILS to SBO requiring surgical treatment, and we conducted a retrospective study to clarify the role of SILS in the management of SBO. Read More

Cureus 2020 Apr 24;12(4):e7821. Epub 2020 Apr 24.

Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, IND.

Introduction Acetabular fractures are complex intra-articular fractures. The extra-pelvic ilioinguinal (IL) has been the workhorse for the anterior approach and remains the gold standard. The major difference between the IL and the Stoppa approaches is that Stoppa allows for the avoidance of the middle window of the IL approach. Read More

BMJ Case Rep 2020 May 27;13(5). Epub 2020 May 27.

Department of Paediatric Surgery, Nottingham University Hospital NHS Trust, Nottingham, UK.

An 8-year-old boy with a history of multiple neonatal laparotomies, including congenital diaphragmatic hernia repair and an open fundoplication, presented acutely with severe abdominal pain, distension, vomiting and shock. A large abnormal opacity in the left upper quadrant was visible on a plain abdominal radiograph. The patient was taken to the theatre for emergency laparotomy and was found to have a massively distended stomach, the fundus and body of which were necrotic. Read More

BJS Open 2020 May 28. Epub 2020 May 28.

Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

Background: Many patients develop seroma after laparoscopic ventral hernia repair. It was hypothesized that leaving the hernial sac in situ may cause this complication.

Methods: In this patient- and outcome assessor-blinded, parallel-design single-centre trial, patients undergoing laparoscopic intraperitoneal onlay mesh ventral hernia repair were randomized (1 : 1) to either conventional fascial closure or peritoneal bridging. Read More

Ultrasound Obstet Gynecol 2020 May 27. Epub 2020 May 27.

Antoine Béclère Hospital, Gynecology and Obstetrics Department, Clamart, Paris Sud University, France.

Objective: The long-term morbidity of isolated left-sided congenital diaphragmatic hernia (L-CDH) has already been described. However, antenatal criteria impacting gastrointestinal morbidity (GIM) are not yet defined. The objective of this study was to evaluate the effect of fetal stomach position on GIM at 2 years. Read More

Aktuelle Urol 2020 May 27. Epub 2020 May 27.

Heinrich-Heine-Universität, Medizinische Fakultät, Klinik für Urologie, Düsseldorf.

Even today, radical cystectomy with urinary diversion is one of the most complicated procedures in uro-oncology. Particularly in the long-term course, but also perioperatively, problems caused by urinary diversion play a significant role.Perioperatively, gastrointestinal problems such as an ileus, but also infections and early complications of the different anastomoses are most important. Read More

Iran J Public Health 2020 Feb;49(2):257-266

Department of Internal Medicine-Oncology, Jingjiang People's Hospital, Jingjiang, China.

Background: We aimed to detect IL-17, MMP-9 and CD23 in serum of patients with colorectal cancer to provide some proper references for diagnosis and treatment of this disease.

Methods: Overall, 287 patients with colorectal cancer were collected in the Digestive Surgery Department of Chinese PLA General Hospital, Beijing, China from January 2017 to November 2018 and were used as the study group, meanwhile, 200 people who took physical examination in the same period were used as the control group. They were retrospectively analyzed. Read More

Surgery 2020 May 24. Epub 2020 May 24.

Department of Surgery and Centre for Surgical Science, Zealand University Hospital, Denmark.

Background: Smoking and obesity are well-known risk factors for surgical site infection, but it is unknown whether these factors influence outcomes after repair of small umbilical and epigastric hernias with defects ≤2 cm. The aim of this study was to evaluate whether smoking and obesity are associated with readmission, reoperation for complications, and recurrence rates after elective repair of small umbilical and epigastric hernias.

Methods: Data on hernia type, size, repair method, smoking status, and body mass index after elective repair were available from the Danish Hernia Database from January 2017 through December 2018. Read More

Obes Surg 2020 May 26. Epub 2020 May 26.

İstanbul Bariatrics, Obesity and Advanced Laparoscopy Center, Hakkı Yeten Cad, Yeşil Çimen Sok, Polat Tower, Şişli, 34394, İstanbul, Turkey.

Concurrent surgical treatment of an intra-gastric stomach + morbid obesity is demonstrated. Video footage on diagnosis (gastroscopy and upper GI series) and surgical steps, as well as 2-year outcome (upper GI series), is presented. Although controversy exists regarding the best bariatric option when concomitantly repairing a giant para-esophageal hernia, in the light of recent reports and our own experience, sleeve gastrectomy may be the procedure of choice if reflux is no issue. Read More

Langenbecks Arch Surg 2020 May 24. Epub 2020 May 24.

Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.

Purpose: Laugier's hernia is a rare clinical entity compared with a typical femoral hernia. Therefore, the clinical features, radiological findings, and appropriate treatment strategies remain largely unclear. In this study, we present 15 Laugier's hernia cases. Read More

BMJ Open 2020 May 25;10(5):e038196. Epub 2020 May 25.

Department of Surgery, Amsterdam UMC - Locatie AMC, Amsterdam, Noord-Holland, Netherlands

Introduction: Surgical site infections (SSI) are a common postoperative complication. During the development of the new WHO guidelines on SSI prevention, also in the Netherlands was concluded that perioperative care could be optimised beyond the current standard practice. We selected a limited set of readily available, cheap and evidence-based interventions from these new guidelines that are not part of standard practice in the Netherlands and formulated an Enhanced PeriOperative Care and Health bundle (EPOCH). Read More

Surg Obes Relat Dis 2020 Apr 19. Epub 2020 Apr 19.

Clinique de Chirurgie Cancérologique Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, Centre Hospitalo-universitaire de Nantes (CHU) Hôtel-Dieu, Nantes, France; L'institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France. Electronic address:

Background: Obesity is well known to increase the risk of gastroesophageal reflux disease (GERD). The impact of sleeve gastrectomy (SG) on GERD is still discussed but seems to be associated with the development of de novo GERD or the exacerbation of preexisting GERD.

Objective: The objective of this study was to evaluate the impact of preoperative pH monitoring, using the DeMeester score (DMS), on the risk of conversion to Roux-en-Y gastric bypass (RYGB) after SG. Read More

Surgery 2020 May 23. Epub 2020 May 23.

Surgical Oncology Unit. Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.

Minerva Chir 2020 May 26. Epub 2020 May 26.

Unit of Digestive Surgery, Department of Surgery and Translational Medicine, Florence University Hospital, University of Florence, Florence, Italy.

Background: Hernia repair is one of the most frequent operation in general surgery. The aim of this is study is to present a new preperitoneal atraumatic dissection of peritoneal flap during laparoscopic transabdominal preperitoneal inguinal hernia repair.

Methods: From January 2019 to Dicember 2019, 30 patients (19 male, 11 female) attended and woman; bilateral inguinal hernia. Read More

J Laparoendosc Adv Surg Tech A 2020 May 21. Epub 2020 May 21.

Bariatric Surgery, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.

Obesity predisposes patients to the development of abdominal wall hernias. Ventral hernia incidence, size, and recurrence rate are all increased in this population. As such, the surgeon is likely to encounter patients presenting for metabolic and bariatric surgery with existing ventral hernias. Read More

Asian J Endosc Surg 2020 May 25. Epub 2020 May 25.

Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.

We report a case of a diaphragmatic hernia after a heart transplant operation. A 43-year-old woman, who underwent orthotropic heart transplantation for hypertrophic cadiomyopathy two year earlier, presented with vomiting and epigastric pain. A computed tomography scan showed that the stomach and transverse colon were dislocated in the left thoracic cavity. Read More

Hernia 2020 May 25. Epub 2020 May 25.

CQInsights, Knoxville, TN, USA.

Purpose: The use of hernia mesh is a common practice in abdominal wall reconstruction (AWR) operations. The high cost of biologic mesh has raised questions about the value of its use in AWR. Resorbable synthetic mesh may have the potential benefits of biologic mesh, minimizing the need for removal when infected, at a lower cost. Read More

Hernia 2020 May 25. Epub 2020 May 25.

Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.

Purpose: It is difficult to manage the full-thickness defect that is created by radical resection of an abdominal wall tumor. This report aimed to review our institutional experience with immediate reconstruction using mesh reinforcement after abdominal wall tumor resection.

Methods: We retrospectively examined patients who underwent abdominal wall tumor resection with immediate mesh-reinforced reconstruction between April 2014 and November 2018. Read More

Hernia 2020 May 25. Epub 2020 May 25.

Center of Research On the Pathology and High Specialization On the Abdominal Wall and Hernia Surgery, Milano Hernia Center, Istituto Clinico Sant'Ambrogio, Via Faravelli 16, 20147, Milano, Italy.

Purpose: The aim of this paper is to propose our four-step technique, an open extraperitoneal approach for complex flank, lumbar, and iliac hernias.

Methods: A big polypropylene mesh is placed, covering and reinforcing all the lateral abdominal wall in an extraperitoneal space. Its borders are retroxiphoid fatty triangle and the costal arch cranially and the retropubic space caudally, psoas muscle, and paravertebral region posteriorly and contralateral rectus muscle medially. Read More

Hernia 2020 May 25. Epub 2020 May 25.

First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.

Purpose: To identify and sum all available evidence pertaining to the management of Amyand's hernia (AH).

Methods: A systematic search of the MedLine, Scopus, and Google Scholar databases was performed for studies published until January 2020.

Results: In total, 111 studies incorporating 161 patients were identified, 96 (86. Read More

Int J Colorectal Dis 2020 May 25. Epub 2020 May 25.

Spectrum Health General Surgery Residency, 100 Michigan NE, Suite A501, Grand Rapids, MI, 49503, USA.

Purpose: Our aims were to determine the rate of incisional hernia after closure of a loop ileostomy (LI) and to identify any perioperative risk factors that may be associated with hernia development.

Methods: We performed an IRB-approved retrospective review that included consecutive patients who underwent LI closure from January 1, 2012, to December 31, 2014. The primary outcome was identification of hernia on physical exam or by abdominal imaging. Read More

Int J Colorectal Dis 2020 May 25. Epub 2020 May 25.

Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.

Background: Parastomal evisceration is a very uncommon complication of stomas with only few cases reported in the literature. This complication can be developed in the early postoperative period due to technical aspects of stoma creation, but late parastomal evisceration appearing after 6 months from surgery is an exceptional condition. Herein, we present a rare case of a patient with late parastomal evisceration. Read More

Surg Case Rep 2020 May 25;6(1):114. Epub 2020 May 25.

Division of Advanced Surgical Science and Technology, Graduate School of Medicine, University of Tohoku, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.

Background: While anastomotic leakage, recurrent laryngeal nerve paralysis, and pneumonia are well-known complications of esophagectomy, the incidence of hiatal hernia after esophagectomy for carcinoma has been reported to only be between 0.6 and 10%. We report a very rare case of hiatal hernia with transverse colon rupture in the mediastinum after esophagectomy in a 65-year-old woman. Read More

Surg Innov 2020 May 23:1553350620917898. Epub 2020 May 23.

Maastricht University Medical Center, Maastricht, Netherlands.

. This pilot study evaluates if an electronic nose (eNose) can distinguish patients at risk for recurrent hernia formation and aortic aneurysm patients from healthy controls based on volatile organic compound analysis in exhaled air. Both hernia recurrence and aortic aneurysm are linked to impaired collagen metabolism. Read More

Hernia 2020 May 24. Epub 2020 May 24.

Department of Colorectal Surgery, Morriston Hospital, Swansea, SA6 6NL, UK.

Background: Achieving stable closure of complex or contaminated abdominal wall incisions remains challenging. This study aimed to characterise the stage of innovation for bioabsorbable mesh devices used during both midline closure prophylaxis and complex abdominal wall reconstruction and to evaluate the quality of current evidence.

Methods: A systematic review of published and ongoing studies was performed until 31st December 2019. Read More

J Thorac Cardiovasc Surg 2020 Apr 6. Epub 2020 Apr 6.

Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn. Electronic address: