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A Case of Extreme Skeletal Class III Malocclusion Beyond the Envelope of Discrepancy, Managed Effectively by a Modified Ortho-Surgical Protocol.

J Maxillofac Oral Surg 2021 Jun 27;20(2):201-218. Epub 2020 Mar 27.

Command Military Dental Centre (Northern Command), Udhampur, Jammu and Kashmir India.

Introduction: Correction of a severe anteroposterior skeletal discrepancy, as described in this case of extreme skeletal class III malocclusion, can be quite challenging and fraught with difficulties. Conventional, single-stage bi-jaw orthognathic surgery with pre-and post-surgical orthodontics is associated with drawbacks such as the risk of relapse and an unsatisfactory overall long-term outcome, with persisting occlusal discrepancies and skeletal abnormalities, especially when the magnitude of skeletal correction required is large. Excessive mandibular setback can restrict tongue space, cause narrowing of posterior airway and pharyngeal space, and be prone to relapse from the forward pterygomasseteric muscle pull, while large maxillary advancements are often accompanied by wound dehiscence and bone exposure at the site of pterygomaxillary disjunction, delayed union or malunion at the osteotomy and disjunction sites, and risk of relapse due to backward palatopharyngeal muscle pull. Read More

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SPHINCTEROTOMY ALONE VERSUS SPHINCTEROTOMY AND BILIARY STENT PLACEMENT IN THE TREATMENT OF BILE LEAKS: 10 YEAR EXPERIENCE AT A QUATERNARY HOSPITAL.

Arq Gastroenterol 2021 Jan-Mar;58(1):71-76

Faculdade Santa Marcelina, São Paulo, Brasil.

Background: Hepatobiliary surgery and hepatic trauma are frequent causes of bile leaks and this feared complication can be safely managed by endoscopic retrograde cholangiopancreatography (ERCP). The approach consists of sphincterotomy alone, biliary stenting or a combination of the two but the optimal form remains unclear.

Objective: The aim of this study is to compare sphincterotomy alone versus sphincterotomy plus biliary stent placement in the treatment of post-surgical and traumatic bile leaks. Read More

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A case of extreme skeletal class III Malocclusion beyond the envelope of discrepancy, managed effectively by a modified ortho-surgical protocol.

JPRAS Open 2021 Jun 25;28:110-120. Epub 2020 Dec 25.

Classified Specialist (Orthodontia), Command Military Dental Centre (Northern Command), Jammu & Kashmir, India.

Correction of severe anteroposterior skeletal discrepancy, as described in this case of Extreme Skeletal Class III Malocclusion, can be challenging and fraught with difficulties. Conventional, single stage Bi-jaw Orthognathic surgery, with pre-and post-surgical orthodontics is associated with drawbacks such as risk of relapse and an unsatisfactory outcome, with persisting occlusal discrepancies and skeletal abnormalities, especially when the magnitude of skeletal correction is large. Excessive mandibular setback restricts tongue space, narrows the posterior airway and pharyngeal spaces, and is prone to relapse from the forward pterygomasseteric pull; while large maxillary advancements are accompanied by wound dehiscence, bone exposure and delayed union at the site of pterygomaxillary disjunction, and risk of relapse due to backward palatopharyngeal pull. Read More

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Systems Biology Guided Gene Enrichment Approaches Improve Prediction of Chronic Post-surgical Pain After Spine Fusion.

Front Genet 2021 23;12:594250. Epub 2021 Mar 23.

Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.

Objectives: Incorporation of genetic factors in psychosocial/perioperative models for predicting chronic postsurgical pain (CPSP) is key for personalization of analgesia. However, single variant associations with CPSP have small effect sizes, making polygenic risk assessment important. Unfortunately, pediatric CPSP studies are not sufficiently powered for unbiased genome wide association (GWAS). Read More

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Predictive factors of stereopsis outcomes following strabismus surgery.

Ther Adv Ophthalmol 2021 Jan-Dec;13:25158414211003001. Epub 2021 Mar 24.

Department of Ophthalmology, Olmsted Medical Center, Rochester, MN, USA.

Purpose: To determine the predictive factors of post-operative stereopsis in patients with strabismus.

Method: In this retrospective study, records of patients who received surgical treatment for strabismus were reviewed. All types of strabismus were included. Read More

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Chinese Association for the Study of Pain: Expert consensus on chronic postsurgical pain.

World J Clin Cases 2021 Mar;9(9):2090-2099

Department of Algology, The Affiliated T.C.M Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.

Chronic postsurgical pain is a common surgical complication that severely reduces a patient's quality of life. Many perioperative interventions and management strategies have been developed for reducing and managing chronic postsurgical pain. Under the leadership of the Chinese Association for the Study of Pain, an editorial committee was formed for chronic postsurgical pain diagnosis and treatment by experts in relevant fields. Read More

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Surgical Risk Following Anatomic Lung Resection in Thoracic Surgery: A Prediction Model Derived from a Spanish Multicenter Database.

Arch Bronconeumol 2021 Feb 24. Epub 2021 Feb 24.

Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, España.

Introduction: The aim of this study was to develop a surgical risk prediction model in patients undergoing anatomic lung resections from the registry of the Spanish Video-Assisted Thoracic Surgery Group (GEVATS).

Methods: Data were collected from 3,533 patients undergoing anatomic lung resection for any diagnosis between December 20, 2016 and March 20, 2018. We defined a combined outcome variable: death or Clavien Dindo grade IV complication at 90 days after surgery. Read More

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February 2021

Thyroid malignancy rates according to the Bethesda reporting system in Israel - A multicenter study.

Eur J Surg Oncol 2021 Mar 15. Epub 2021 Mar 15.

Department of Otolaryngology, Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.

Introduction: The Bethesda System for Reporting Thyroid Cytopathology was developed in 2007 to facilitate an accurate, reproducible communication of thyroid fine-needle aspiration (FNA) interpretations between clinicians and cytopathologists and to serve as a guide for treatment. Based on large patient series, the system details the risk of malignancy for each category as well as a suggested management for each FNA result. Though this system has been widely adopted, there are only few studies to determine whether results are applicable for Israel. Read More

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The role of cross-link augmentation on fusion rate and patient satisfaction among patients with traumatic thoracolumbar spinal fracture: A randomized clinical trial.

Neurocirugia (Astur) 2021 Mar 3. Epub 2021 Mar 3.

Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran.

Introduction And Objectives: Most of the studies evaluating the effect of cross links on spinal stability are performed in vitro on porcine or human spine segments and there is limited data regarding clinical benefits of cross link augmentation in traumatic injuries. In this study we aimed to evaluate the effects of cross-links insertion between rods on the fusion rates and post-surgical patients' satisfaction among patients with traumatic thoracolumbar fractures who underwent posterior spinal fixation with pedicle screws.

Materials And Methods: This study was conducted as a randomized clinical trial on 60 patients suffering from traumatic thoracolumbar vertebrae fractures. Read More

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The Impact of Postoperative Complications on Long-Term Oncological Outcomes Following Curative Resection of Colorectal Cancer (Stage I-III): A Systematic Review and Meta-Analysis.

Cureus 2021 Jan 21;13(1):e12837. Epub 2021 Jan 21.

Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.

Background and objective The incidence of post-surgical complications (PSCs) after curative resection of non-metastatic colorectal cancer (CRC) is very widespread and evident. Some studies suggest that PSCs often predict poor long-term oncological outcomes. However, the available data on the topic is often controversial. Read More

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January 2021

Microbiomics of irrigation with xylitol or in chronic rhinosinusitis.

Laryngoscope Investig Otolaryngol 2021 Feb 21;6(1):64-70. Epub 2021 Jan 21.

Department of Otolaryngology Head and Neck Surgery University of Rochester Medical Center Rochester New York USA.

Objective: Topical sinonasal rinse therapies may alter the local microbiome and improve disease control in chronic rhinosinusitis (CRS). The objective of this study was to examine microbiome changes in post-surgical CRS patients when rinsing with commercially available products containing xylitol or .

Methods: A crossover-type protocol with a washout period was designed. Read More

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February 2021

The effect of pedicle subtraction osteotomy for the correction of severe Scheuermann thoracolumbar kyphosis on sagittal spinopelvic alignment.

BMC Musculoskelet Disord 2021 Feb 10;22(1):165. Epub 2021 Feb 10.

Departments of Orthopaedic Surgery, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences; State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital(PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Hutong, Beijing, 100730, People's Republic of China.

Purpose: To analyze how pedicle subtraction osteotomy (PSO) treatment of severe Scheuermann thoracolumbar kyphosis (STLK) using pedicle screw instrumentation affects sagittal spinopelvic parameters.

Background: The medical literature on the post-surgical effects of treatments such as Ponte osteotomy is limited, but suggests few effects on spinopelvic profiles. Currently, there is no research regarding changes in sagittal spinopelvic alignment upon PSO treatment in STLK patients. Read More

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February 2021

Impact of perioperative intravenous lidocaine infusion on postoperative pain and rapid recovery of patients undergoing gastrointestinal tumor surgery: a randomized, double-blind trial.

J Gastrointest Oncol 2020 Dec;11(6):1274-1282

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.

Background: To explore the effect of perioperative intravenous lidocaine infusion on postoperative pain and the rapid recovery of patients undergoing gastrointestinal tumor surgery.

Methods: The patients who underwent gastrointestinal tumor surgery from May to July 2020 were selected. The patients were randomly divided into the lidocaine group (group L) and control group (group C) by the random number table method, with 60 patients in each group. Read More

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December 2020

Does early surgery prevent Postoperative ICU admission after surgery for the fracture of the hip. Nested case control study of 911 patients.

Ann Med Surg (Lond) 2021 Jan 17;61:35-40. Epub 2020 Dec 17.

Department of surgery, Section of orthopedics, The Aga Khan University hospital, Pakistan.

Introduction: Since most hip fractures are treated surgically, it is imperative to find an optimum fracture-to-surgery time to decrease the potential complications and enhance postoperative outcomes. In comparison to the vast plethora of literature available on surgical delay and its implications on mortality, very little, if any, research is available on the impact of delayed surgery on postoperative ICU admission. The primary objective of our study is to examine the factors influencing post-surgical ICU admission in order to work on preventive strategies to reduce the potential associated morbidity. Read More

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January 2021

Trapeziometacarpal osteoarthritis: Arthroscopic hemitrapeziectomy using the Thenar Portal.

Orthop Traumatol Surg Res 2020 Dec 14:102793. Epub 2020 Dec 14.

Department of Orthopaedics, Italian Hospital of Buenos Aires, C1199ACK, 4215 Potosí, Buenos Aires, Argentina.

Background: Although the standard 1Radial and 1Ulnar portals allow for visualisation of most of the trapezium articular surface, the proximity of these two portals can often make arthroscopic triangulation and visualisation of the most lateral capsule and joint surface challenging. Despite its already reported advantages in improving visualisation, there is little literature reporting the clinical experience with the Thenar Portal. The purpose of this study is to describe potential complications and the short-term clinical-radiographic outcomes of arthroscopic hemitrapeziectomy using the Thenar Portal in order to determine its safety and efficacy as a standard working portal. Read More

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December 2020

Long-Term Surgical Results of Skip Pedicle Screw Fixation for Patients with Adolescent Idiopathic Scoliosis: A Minimum-Ten-Year Follow-Up Study.

J Clin Med 2020 Dec 10;9(12). Epub 2020 Dec 10.

Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.

Skip pedicle screw fixation for adolescent idiopathic scoliosis (AIS) requires fewer screws and can reduce the risk of neurovascular injury as compared with segmental pedicle screw fixation. However, the long-term impact of screw number reduction on correction and clinical results is unclear. This study examined the 10-year post-operative outcomes of skip pedicle screw fixation for patients with AIS. Read More

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December 2020

Key factors influencing clinical and functional outcomes in extracapsular proximal femur fractures: the role of early weight-bearing - one-year follow-up cohort of 495 patients.

Med Glas (Zenica) 2021 02;18(1):280-286

Orthopaedic Surgery Department, University Hospital Centre of Toledo, Toledo, Spain.

Aim To establish a correlation between immediate post-surgical weight bearing in extracapsular hip fractures and final functional outcome as well as to study the correlation between immediate post-surgical weight bearing and morbidity and mortality during the first year. Methods Retrospective observational cohort study including 495 consecutive patients ≥75 years old operated of extracapsular proximal femur fracture. Medical records were reviewed and information of demographic data, radiological evolution, time to weight-bearing, mortality rate, medical and surgical complications and final ambulation status were recorded. Read More

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February 2021

Social determinants of health and outcomes for children and adults with congenital heart disease: a systematic review.

Pediatr Res 2021 Jan 17;89(2):275-294. Epub 2020 Oct 17.

Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA.

Background: Social determinants of health (SDH) can substantially impact health outcomes. A systematic review, however, has never been conducted on associations of SDH with congenital heart disease (CHD) outcomes. The aim, therefore, was to conduct such a systematic review. Read More

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January 2021

Impact of ictal subtraction SPECT and PET in presurgical evaluation.

Acta Neurol Scand 2021 Mar 10;143(3):271-280. Epub 2020 Nov 10.

Comprehensive Epilepsy Program, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Objective: To assess the relative contribution of ictal subtraction single-photon emission computed tomography (ISSPECT) and F-fluorodeoxyglucose positron emission tomography computed tomography (PET) in epilepsy surgery decision making.

Materials And Methods: A retrospective 3-year study of consecutive patients with resistant focal epilepsy who underwent ISSPECT and PET to evaluate to what extent these modalities influence decisions in epilepsy surgery and outcomes. ISSPECT imaging was performed in 106 patients and 58 (55%) had PET also. Read More

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Fully Implanted Prostheses for Musculoskeletal Limb Reconstruction After Amputation: An In Vivo Feasibility Study.

Ann Biomed Eng 2021 Mar 9;49(3):1012-1021. Epub 2020 Oct 9.

Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, 1512 Middle Dr, Knoxville, TN, 37966, USA.

Previous prostheses for replacing a missing limb following amputation must be worn externally on the body. This limits the extent to which prostheses could physically interface with biological tissues, such as muscles, to enhance functional recovery. The objectives of our study were to (1) test the feasibility of implanting a limb prosthesis, or endoprosthesis, entirely within living skin at the distal end of a residual limb, and (2) identify effective surgical and post-surgical care approaches for implanting endoprostheses in a rabbit model of hindlimb amputation. Read More

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Transhepatic endovascular repair for portal vein haemorrhage.

CVIR Endovasc 2020 Oct 8;3(1):56. Epub 2020 Oct 8.

Assistance Publique - Hôpitaux de Paris (AP-HP), Service d'Imagerie Médicale, Hôpital Henri-Mondor, Créteil, France.

Background: Post-surgical bleeding of the main portal vein (PV) is a rare event but difficult to manage surgically. Among the different options of treatment, endovascular stenting of the PV can be considered. We reported two cases of stent-graft placement in PV with subsequent closure of the portal vein access with two percutaneous closure devices deployed simultaneously. Read More

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October 2020

Navigated Antral Bone Expansion (NABE): a prospective study on 35 patients with 4 months of follow-up post implant loading.

BMC Oral Health 2020 10 7;20(1):273. Epub 2020 Oct 7.

Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 6. Caserta St., 00161, Rome, Italy.

Background: The insertion of dental implants in the atrophic posterior maxilla can be a challenge. One option is to modify the residual native bone in preparation for proper, prosthetically-driven implant placement. The procedure presented in this study is called Navigated Antral Bone Expansion (N. Read More

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October 2020

Orthodontics First in Hemimandibular Hyperplasia. "Mind the Gap".

Int J Environ Res Public Health 2020 09 28;17(19). Epub 2020 Sep 28.

Division of Orthodontics, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80138 Naples, Italy.

A 32-year-old man was referred to the Division of Orthodontics of the University of Naples "Federico II", with a 15-year history of gradually increasing right-sided facial asymmetry. Clinical and radiological examinations was consistent to hemimandibular hyperplasia, a rare developmental asymmetry characterized by three-dimensional enlargement of one-half of the mandible. The standard surgical-orthodontic management was proposed to the patient. Read More

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September 2020

Correlation and regression analysis between residual gradation and uncorrected visual acuity one year after refractive surgery with LASIK, FS-LASIK, PRK, PRK Xtra techniques and the implantation of ICL® posterior chamber phakic lens in myopic correction.

PLoS One 2020 11;15(9):e0238399. Epub 2020 Sep 11.

Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.

Purpose: To analyze the influence of the final spherical equivalent (SE) in LogMAR uncorrected distance visual acuity (UDVA) one year after refractive surgery. We analysed refractive results, their predictability and efficacy, and the safety results of the different methods as secondary outcomes.

Setting: Refractive Surgery Unit of the Institut Català de Retina (ICR) in Barcelona, Spain. Read More

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October 2020

Feasibility in the echocardiographic estimation of parameters of the right ventricle in prone position.

Arch Cardiol Mex 2020 ;90(2):116-123

Department of Cardiovascular Post-Surgical Intensive Care, Instituto Nacional de Cardiología Ignacio Chávez, Secretaría de Salubridad y Asistencia, Mexico City, Mexico.

Background: Echocardiographic cardiac parameters in the prone position are usually obtained with an esophageal probe. The feasibility of obtaining them by means of a transthoracic approach is unknown.

Objective: Estimating the feasibility to obtain parameters of the right ventricle by transthoracic echocardiography in prone position on the subject. Read More

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January 2020

Infection rate of intramedullary nailing for treatment of lower limb polyostotic fibrous dysplasia.

J Biol Regul Homeost Agents 2020 May-Jun;34(3 Suppl. 2):47-52

Department of Orthopaedic Surgery, University of Rome "Tor Vergata" Italy.

Polyostotic fibrous dysplasia (PFD) generally cause deformities and fractures of femur and tibia and surgery is often required. The current surgical treatment for deformities is based on single or multiple osteotomies followed by stabilization with intramedullary nails, which are commonly used also for fractures. One of the most common surgical complications of intramedullary nailing is represented by surgical site infection with possible extension to the whole skeletal segment. Read More

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November 2020

Use of Fractional CO2 Laser in Cleft Lip Scars: Does It Make a Difference?

Ann Plast Surg 2021 May;86(5):536-539

From the Plastic Surgery Department, Assiut University Hospital, Assiut, Egypt.

Background: Whatever the technique of the surgical repair, the scar remains and it is the most common cause for parent's and patient's dissatisfaction. We aimed in this work to evaluate the efficacy of the fractional CO2 (FCO2) laser on the later appearance of cleft lip scars in general and to compare between the early and late use of this tool to know its ideal application time in particular. To our knowledge, there are no published reports about this objective with regard to the number of patients and the concerned designated study. Read More

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Overview of the Clinical Benefits Using the Different Diode Laser Wavelengths in Treatment of the Mucocele: Clinical Cases Report Review.

Photobiomodul Photomed Laser Surg 2020 Aug;38(8):497-506

Al Asmarya University, College of Dentistry and Oral Surgery, Zliten, Libya.

Diode laser has a wide range of wavelengths that may render the absorption effect and interaction with the tissue is different. Based on available evidences, the aim of this review is to critically evaluate the use of different diode laser wavelengths in the treatment of mucocele. The literature of clinical case studies for the past 8 years has been considered. Read More

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Autogenous Osteochondral Grafting for Treatment of Knee Osteochondritis Dissecans: A Case Series Study.

Arch Bone Jt Surg 2020 May;8(3):426-431

Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of medical Sciences, Tehran, Iran.

Background: Although some surgical techniques have been described for the operative treatment of unstable Osteochondritis dissecans (OCD) of the knee, outcomes are variable and are not satisfying totally. The aim of the present study is to evaluate the outcomes of autogenous osteochondral grafting for OCD of the knee.

Methods: In a case series study, from June 2014 to July 2015, 16 patients with stage II-IV OCD (International Cartilage Repair Society (ICRS)) of the femoral condyle were investigated. Read More

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Characteristics of Postoperative Pain After VATS and Pain-Related Factors: The Experience in National Cancer Center of China.

J Pain Res 2020 21;13:1861-1867. Epub 2020 Jul 21.

Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China.

Purpose: No final conclusion has yet been reached on characteristics of postoperative pain and pain-related factors after video-assisted thoracoscopic surgery (VATS). This study was designed to explore features of acute severe pain and chronic post-surgical pain (CPSP), and the pain-related factors of VATS.

Patients And Methods: Data of patients who underwent VATS for lung cancer in Cancer Hospital, Chinese Academy of Medical Sciences between March 2017 and January 2019 were reviewed in this retrospective study. Read More

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