{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:12:08Z","timestamp":1780391528224,"version":"3.54.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hernia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Symptomatic groin hernias typically require surgical intervention, through either open or minimally invasive techniques. Among these, the Lichtenstein tension-free repair remains the gold standard for open procedures and is widely adopted today. Conventionally, patients are advised on convalescence and the timeline for resuming daily activities according with surgeons expertize. This study is based on the premise that structured physical rehabilitation can accelerate recovery and can facilitate an earlier return to work. Therefore, the goal was to evaluate the impact of a combined preoperative and post-operative exercise program as there is limited data that prehabilitation may decrease the period of convalescence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      A prospective randomized case \u2013control study was conducted between January 1, 2023, and December 31, 2024, enrolling patients with primary unilateral reducible non-scrotal groin hernias. Participants were blindly randomised according to rehabilitation in a study group (receiving physical rehabilitation) and a control group (without rehabilitation). Baseline parameters including age, gender BMI (kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), comorbidities and symptoms onset were recorded for all participants. Preoperative hernia - induced disability was assessed using the Pain Disability Index (PDI).Abdominal wall functionality was evaluated through clinical validated tests: Trunk Raising (TR), Double Leg Lowering (DLL), and a Total Score (TS) calculated as the sum of TR and DLL. The assessments were performed preoperatively, as well as at 7 and 30 days postoperatively. Acute postoperative pain was recorded at 24 and 72\u00a0h using the Visual Analogue Scale (VAS). The primary endpoint was the time to return to work, assessing the overall impact of rehabilitation on convalescence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 194 patients (97 per group) were analysed. Preoperatively, the study group exhibited significantly higher disability (PDI 56.7\u2009\u00b1\u20092.51 vs. 53.05\u2009\u00b1\u20092.74;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and lower abdominal functionality (AWF 5.15\u2009\u00b1\u20091.4 vs. 6.48\u2009\u00b1\u20091.34;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to controls, with baseline pain levels remaining similar (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.937). Postoperatively, at 24\u00a0h, the control group experienced significantly higher VAS scores, particularly during mobilization (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). By day 7, PDI reduction was markedly more pronounced in the rehabilitation group (18.48\u2009\u00b1\u20094.31 vs. 13.59\u2009\u00b1\u20093.83;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with a higher proportion of patients achieving the Minimal Important Change (61 vs. 42;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). While AWF scores decreased significantly in controls by day 7 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), the study group maintained stability, reaching significantly higher mean AWF scores (7.77\u2009\u00b1\u20091.02 vs. 7.29\u2009\u00b1\u20090.92;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and superior functional recovery by day 30 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Crucially, the rehabilitation group returned to work significantly earlier (9.28\u2009\u00b1\u20094.47 vs. 12.86\u2009\u00b1\u20095.16 days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariate regression identified preoperative PDI, functionality score, and symptom onset as independent predictors for both acute pain and early return to work (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). During a mean follow-up of 18.4\u2009\u00b1\u20093.6 months, no recurrences were reported, and minor complications (hematoma, seroma, chronic pain) showed no significant differences between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05), confirming the protocol\u2019s safety.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rehabilitation with physical therapy reduce disability, increase abdominal function and reduces the convalescence period after groin hernia repair in accordance with the actual guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10029-026-03729-0","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T08:30:48Z","timestamp":1780389048000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The efectiveness of perioperative abdominal wall exercises upon functional recovery and return to work after Lichtenstein tension \u2013 free repair: a prospective randomized case \u2013control study"],"prefix":"10.1007","volume":"30","author":[{"given":"R.","family":"Trisca","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5478-4662","authenticated-orcid":false,"given":"Valentin","family":"Oprea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Toma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Cadar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. E.","family":"Bucuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Finascu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Andercou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Bodog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. R.","family":"Matei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Siserman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Chiroban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Gherman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"issue":"5","key":"3729_CR1","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1016\/S0039-6109(03)00132-4","volume":"83","author":"IM Rutkow","year":"2003","unstructured":"Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 83(5):1045\u20131051. https:\/\/doi.org\/10.1016\/S0039-6109(03)00132-4","journal-title":"Surg Clin North Am"},{"key":"3729_CR2","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1007\/s10029-021-02377-w","volume":"26","author":"S Schaaf","year":"2022","unstructured":"Schaaf S, Willms A, Schwab R et al (2022) Recommendations on postoperative strain and physical labor after abdominal and hernia surgery: an expert survey of attendants of the 41st EHS Annual International Congress of the European Hernia Society. Hernia 26:727\u2013734. https:\/\/doi.org\/10.1007\/s10029-021-02377-w","journal-title":"Hernia"},{"key":"3729_CR3","doi-asserted-by":"publisher","first-page":"713138","DOI":"10.3389\/fsurg.2021.713138","volume":"29","author":"S Schaaf","year":"2021","unstructured":"Schaaf S, Schwab R, G\u00fcsgen C, Vilz TO, Willms A (2021) Recommendations on Postoperative Activities After Abdominal Operations and Incisional Hernia Repair-A National and International Survey. Front Surg Sep 29:8:713138. https:\/\/doi.org\/10.3389\/fsurg.2021.713138","journal-title":"Front Surg Sep"},{"key":"3729_CR4","unstructured":"Shologan A (2023) A Pilot Study Examining Feasibility of Perioperative Rehabilitation for Inguinal Hernia Repair Surgery. A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Rehabilitation Science. Faculty of Rehabilitation Medicine University of Alberta, Canada (Accessed on line from https:\/\/ualberta.scholaris.ca\/bitstreams\/e58d4da5-c7a8-4d89-b6ef-bc0b5d02c2e9\/download December 2024"},{"issue":"5","key":"3729_CR5","doi-asserted-by":"publisher","first-page":"e0324907","DOI":"10.1371\/journal.pone.0324907","volume":"20","author":"A Shologan","year":"2025","unstructured":"Shologan A, Farooq O, Bostick G, Macedo L et al (2025) A pilot randomized controlled trial examining the feasibility of perioperative rehabilitation for inguinal hernia repair surgery. PLoS ONE 20(5):e0324907. https:\/\/doi.org\/10.1371\/journal.pone.0324907","journal-title":"PLoS ONE"},{"key":"3729_CR6","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1080\/110241599750007108","volume":"165","author":"T Callesen","year":"1999","unstructured":"Callesen T, Klarskov B, Bech K, Kehlet (1999) Short convalescence after inguinal herniorrhaphy with standardised recommendations: duration and reasons for delayed return to work. Eur J Surg 165:236\u2013241. https:\/\/doi.org\/10.1080\/110241599750007108","journal-title":"Eur J Surg"},{"issue":"1","key":"3729_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10029-017-1668-x","volume":"22","author":"HerniaSurge Group","year":"2018","unstructured":"HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22(1):1\u2013165. https:\/\/doi.org\/10.1007\/s10029-017-1668-x","journal-title":"Hernia"},{"issue":"2","key":"3729_CR8","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1002\/jgf2.600","volume":"24","author":"A Althubaiti","year":"2022","unstructured":"Althubaiti A (2022) Sample size determination: A practical guide for health researchers. J Gen Fam Med 24(2):72\u201378. https:\/\/doi.org\/10.1002\/jgf2.600","journal-title":"J Gen Fam Med"},{"issue":"5","key":"3729_CR9","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1007\/s10029-022-02563-4","volume":"26","author":"V Oprea","year":"2022","unstructured":"Oprea V, Toma M, Grad O, Pavel A, Molnar C (2022) Truncal function after abdominal wall reconstruction via transversus abdominis muscle release (TAR) for large incisional hernias: a prospective case-control study. Hernia 26(5):1285\u20131292. https:\/\/doi.org\/10.1007\/s10029-022-02563-4","journal-title":"Hernia"},{"key":"3729_CR10","doi-asserted-by":"publisher","unstructured":"Jerome A, Gross RT Pain disability index: construct and discriminant validity (1991). Arch Phys Med Rehabil. 72 (11):920\u2013922. https:\/\/doi.org\/10.1016\/0003-9993(91)90012-8","DOI":"10.1016\/0003-9993(91)90012-8"},{"issue":"2","key":"3729_CR11","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/0304-3959(90)90068-O","volume":"40","author":"RC Tait","year":"1990","unstructured":"Tait RC, Chibnall JT, Krause S (1990) The Pain Disability Index: psychometric properties. Pain 40(2):171\u2013182. https:\/\/doi.org\/10.1016\/0304-3959(90)90068-O","journal-title":"Pain"},{"key":"3729_CR12","doi-asserted-by":"publisher","DOI":"10.1007\/s10353-025-00926-6","author":"RH Fortelny","year":"2026","unstructured":"Fortelny RH, Chen D (2026) Modern Lichtenstein tension-free mesh repair: step-by-step operative technique. Eur Surg. https:\/\/doi.org\/10.1007\/s10353-025-00926-6","journal-title":"Eur Surg"},{"key":"3729_CR13","doi-asserted-by":"publisher","first-page":"2392","DOI":"10.1007\/s00268-023-07093-3","volume":"47","author":"V Yin","year":"2023","unstructured":"Yin V, Cobb JP, Wightman SC et al (2023) Centers for Disease Control (CDC) Wound Classification is Prognostic of 30-Day Readmission Following Surgery. World J Surg 47:2392\u20132400. https:\/\/doi.org\/10.1007\/s00268-023-07093-3","journal-title":"World J Surg"},{"key":"3729_CR14","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.3390\/math8101741","volume":"8","author":"A Ciocan","year":"2020","unstructured":"Ciocan A, Hajjar NA, Graur F et al (2020) Receiver Operating Characteristic Prediction for Classification: Performances in Cross-Validation by Example. Mathematics 8:1741. https:\/\/doi.org\/10.3390\/math8101741","journal-title":"Mathematics"},{"key":"3729_CR15","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.sopen.2022.07.002","volume":"10","author":"A Gram-Hanssen","year":"2022","unstructured":"Gram-Hanssen A, Laursen J, Zetner D, Rosenberg J (2022) Postoperative outcomes that matter to patients undergoing inguinal hernia repair: A qualitative study. Surg Open Sci 10:76\u201382. https:\/\/doi.org\/10.1016\/j.sopen.2022.07.002","journal-title":"Surg Open Sci"},{"key":"3729_CR16","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.sopen.2022.07.002","volume":"10","author":"A Gram-Hanssen","year":"2022","unstructured":"Gram-Hanssen A, Laursen J, Zetner D, Rosenberg J (2022) Postoperative outcomes that matter to patients undergoing inguinal hernia repair: A qualitative study. Surg Open Sci 10:76. https:\/\/doi.org\/10.1016\/j.sopen.2022.07.002","journal-title":"Surg Open Sci"},{"key":"3729_CR17","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1111\/j.1445-2197.2006.03746.x","volume":"76","author":"S Mathur","year":"2006","unstructured":"Mathur S, Bartlett ASJR, Gilkison W, Krishna G (2006) Quality of life assessment in patients with inguinal hernia. ANZ J Surg 76:491\u2013493. https:\/\/doi.org\/10.1111\/j.1445-2197.2006.03746.x","journal-title":"ANZ J Surg"},{"key":"3729_CR18","first-page":"341","volume":"54","author":"J Forbes","year":"2012","unstructured":"Forbes J, Fry N, Hamish Hwang and Ahmer Azhar Karimuddin (2012) Timing of return to work after hernia repair: Recommendations based on a literature review. BCMJ 54:341\u2013345","journal-title":"BCMJ"},{"key":"3729_CR19","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1097\/SLA.0000000000002267","volume":"267","author":"A Visioni","year":"2018","unstructured":"Visioni A, Shah R, Gabriel E et al (2018) Enhanced recovery after surgery for noncolorectal surgery? A systematic review and meta-analysis of major abdominal surgery. Ann Surg 267:57\u201365. https:\/\/doi.org\/10.1097\/SLA.0000000000002267","journal-title":"Ann Surg"},{"issue":"8","key":"3729_CR20","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1007\/s00423-012-1008-7","volume":"397","author":"H Buhck","year":"2012","unstructured":"Buhck H, Untied M, Bechstein WO (2012) Evidence-based assessment of the period of physical inactivity required after inguinal herniotomy. Langenbecks Arch Surg 397(8):1209\u20131214. https:\/\/doi.org\/10.1007\/s00423-012-1008-7","journal-title":"Langenbecks Arch Surg"},{"key":"3729_CR21","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/s1479-666x(08)80009-1","volume":"6","author":"PO Hendry","year":"2008","unstructured":"Hendry PO, Paterson-Brown S, de Beaux A (2008) Work related aspects of inguinal hernia: a literature review. Surgeon 6:361\u2013365. https:\/\/doi.org\/10.1016\/s1479-666x(08)80009-1","journal-title":"Surgeon"},{"key":"3729_CR22","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1002\/bjs.4437","volume":"91","author":"M Bay-Nielsen","year":"2004","unstructured":"Bay-Nielsen M, Thomsen H, Andersen FH et al (2004) Convalescence after inguinal herniorrhaphy. Br J Surg 91:362\u2013367","journal-title":"Br J Surg"},{"issue":"9174","key":"3729_CR23","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/S0140-6736(98)10010-7","volume":"354","author":"MRC Laparoscopic Groin Hernia Trial Group","year":"1999","unstructured":"MRC Laparoscopic Groin Hernia Trial Group (1999) Laparoscopic versus open repair of groin hernia: A randomized comparison. Lancet 354(9174):185\u2013190","journal-title":"Lancet"},{"key":"3729_CR24","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1016\/S0039-6060(05)80038-8","volume":"118","author":"JS Barkun","year":"1995","unstructured":"Barkun JS, Wexler MJ, Hinchey EJ et al (1995) Laparoscopic versus open inguinal herniorraphy: preliminary results of a randomized controlled trial. Surgery 118:703\u2013710","journal-title":"Surgery"},{"key":"3729_CR25","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1136\/bmj.311.7011.981","volume":"311","author":"K Lawrence","year":"1995","unstructured":"Lawrence K, McWhinnie D, Goodwin A et al (1995) Randomized controlled trial of laparoscopic versus open repair of inguinal hernia: early results. BMJ 311:981\u2013985","journal-title":"BMJ"},{"key":"3729_CR26","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1056\/NEJM199705293362201","volume":"336","author":"MSL Liem","year":"1997","unstructured":"Liem MSL, van der Graaf Y, van Steensel CJ et al (1997) Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair. N Engl J Med 336:1541\u20131547","journal-title":"N Engl J Med"},{"key":"3729_CR27","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1136\/bmj.311.7000.296","volume":"311","author":"AW Majeed","year":"1995","unstructured":"Majeed AW, Brown S, Williams N, Hannay DR, Johnson AG (1995) Variations in medical attitudes to postoperative recovery period. BMJ 311:296","journal-title":"BMJ"},{"key":"3729_CR28","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1016\/S0140-6736(94)92148-2","volume":"343","author":"DL Stoker","year":"1994","unstructured":"Stoker DL, Spiegelhalter DJ, Singh R, Wellwood JM (1994) Laparoscopic versus open inguinal hernia repair: randomized prospective trial. Lancet 343:1243\u20131245","journal-title":"Lancet"},{"key":"3729_CR29","first-page":"299","volume":"77","author":"AE Kark","year":"1995","unstructured":"Kark AE, Kurzer M, Waters KJ (1995) Tension-free mesh hernia repair: review of 1098 cases using local anesthesia in a day unit. Ann R Coll Surg Engl 77:299\u2013304","journal-title":"Ann R Coll Surg Engl"},{"key":"3729_CR30","first-page":"447","volume":"162","author":"PK Amid","year":"1996","unstructured":"Amid PK, Shulman AG, Lichtenstein IL (1996) Open tensionfree repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 162:447\u2013453","journal-title":"Eur J Surg"},{"key":"3729_CR31","first-page":"754","volume":"35","author":"IL Lichtenstein","year":"1966","unstructured":"Lichtenstein IL (1966) Immediate ambulation and return to work following herniorrhaphy. Indust Med Surg 35:754\u2013759","journal-title":"Indust Med Surg"},{"issue":"6","key":"3729_CR32","doi-asserted-by":"publisher","first-page":"2223","DOI":"10.1007\/s10029-024-03143-4","volume":"28","author":"M Toma","year":"2024","unstructured":"Toma M, Oprea V, Scarlat F et al (2024) Quality of life and abdominal wall functionality after abdominal wall reconstruction: A prospective single center follow-up study. Hernia 28(6):2223\u20132234. https:\/\/doi.org\/10.1007\/s10029-024-03143-4","journal-title":"Hernia"},{"issue":"10","key":"3729_CR33","doi-asserted-by":"publisher","first-page":"2729","DOI":"10.1007\/s11136-021-02925-y","volume":"30","author":"CB Terwee","year":"2021","unstructured":"Terwee CB, Peipert JD, Chapman R et al (2021) Minimal important change (MIC): a conceptual clarification and systematic review of MIC estimates of PROMIS measures. Qual Life Res 30(10):2729\u20132754. https:\/\/doi.org\/10.1007\/s11136-021-02925-y","journal-title":"Qual Life Res"}],"container-title":["Hernia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10029-026-03729-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10029-026-03729-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10029-026-03729-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T08:30:53Z","timestamp":1780389053000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10029-026-03729-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3729"],"URL":"https:\/\/doi.org\/10.1007\/s10029-026-03729-0","relation":{},"ISSN":["1248-9204"],"issn-type":[{"value":"1248-9204","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]},"assertion":[{"value":"9 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All patients sign an informed consent and agreed to be included in the study. The entire research was developed in agreement with the Helsinki Declaration of human rights. Patients agreed to use data in scientific purposes. Local Ethics Council under A2163\/November 2022 approved the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}},{"value":"None of the authors has any conflicts of interest to declare related to this research.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"239"}}