{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T22:07:23Z","timestamp":1771279643951,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Health Sciences"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Updates Surg"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Hyperhidrosis is thought to result from excessive stimulation of sweat glands due to increased sympathetic activity; however, data on systemic responses following bilateral thoracic sympathectomy as the definitive treatment have not yet been sufficiently evaluated. This study, designed as a prospective cohort investigation, included 24 patients who underwent sympathectomy for palmar and axillary hyperhidrosis at our center in 2023, along with an age-matched control group of equal size. In the sympathectomy group, pupillometry measurements were performed 1\u00a0day before surgery and on the 7th postoperative day, while the control group underwent measurements at corresponding intervals. Data from the sympathectomy group were analyzed both preoperatively and postoperatively and compared with the control group. According to the Hyperhidrosis Disease Severity Scale, all patients had severe hyperhidrosis. Sympathectomy was performed at the T3 level in 9 patients and at both T3 and T4 levels in 15 patients. The postoperative satisfaction rate was recorded as 95.8%. No statistically significant differences were observed between preoperative pupillometry measurements of the sympathectomy group and those of the control group. However, when comparing preoperative and postoperative data within the sympathectomy group, significant differences favoring increased parasympathetic activity were noted in the latency of contractions and photopic low values (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.016 and\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.038, respectively). Our study is one of the pioneering works to objectively demonstrate, through a quantitative method, that sympathectomy for hyperhidrosis enhances the parasympathetic system response in the ocular region.\n                  <\/jats:p>","DOI":"10.1007\/s13304-025-02163-8","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T12:51:23Z","timestamp":1741611083000},"page":"461-468","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic effect of sympathectomy in the treatment of localized hyperhidrosis"],"prefix":"10.1007","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5471-2239","authenticated-orcid":false,"given":"Mehmet","family":"\u00c7etin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2230-658X","authenticated-orcid":false,"given":"Furkan","family":"S\u00fcral","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-2345-6789","authenticated-orcid":false,"given":"\u0130lteri\u015f","family":"T\u00fcrk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1046-5410","authenticated-orcid":false,"given":"Necati","family":"Solak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4990-832X","authenticated-orcid":false,"given":"Kenan","family":"S\u00f6nmez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1379-2855","authenticated-orcid":false,"given":"Koray","family":"Aydo\u011fdu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"issue":"11","key":"2163_CR1","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1007\/s11748-024-02034-w","volume":"72","author":"M Kobayashi","year":"2024","unstructured":"Kobayashi M, Kumaya Y, Hirayama Y, Oda H, Cho H, Huang CL (2024) Single-center experience of thoracoscopic sympathectomy for palmar hyperhidrosis with long-term postoperative questionnaire survey. Gen Thorac Cardiovasc Surg 72(11):732\u2013737. https:\/\/doi.org\/10.1007\/s11748-024-02034-w","journal-title":"Gen Thorac Cardiovasc Surg"},{"issue":"4","key":"2163_CR2","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.thorsurg.2016.06.002","volume":"26","author":"CH Schick","year":"2016","unstructured":"Schick CH (2016) Pathophysiology of hyperhidrosis. Thorac Surg Clin 26(4):389\u2013393. https:\/\/doi.org\/10.1016\/j.thorsurg.2016.06.002","journal-title":"Thorac Surg Clin"},{"issue":"4","key":"2163_CR3","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/S0003-4975(00)02767-5","volume":"71","author":"D Gossot","year":"2001","unstructured":"Gossot D, Kabiri H, Caliandro R, Girard P, Stern JB, Debrosse D (2001) Early complications of thoracoscopic sympathectomy: a prospective study of 940 procedures. Ann Thorac Surg 71(4):1116\u20131119. https:\/\/doi.org\/10.1016\/S0003-4975(00)02767-5","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"2163_CR4","doi-asserted-by":"publisher","first-page":"e245","DOI":"10.1093\/neuros\/nyy534","volume":"84","author":"TS Lin","year":"2019","unstructured":"Lin TS, Kuo SJ (2019) Endoscopic thoracic sympathectomy for palmar hyperhidrosis: analysis of 2000 cases. Neurosurgery 84(4):e245\u2013e251. https:\/\/doi.org\/10.1093\/neuros\/nyy534","journal-title":"Neurosurgery"},{"issue":"4","key":"2163_CR5","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1007\/s00464-005-0557-z","volume":"20","author":"J Moya","year":"2006","unstructured":"Moya J, Ramos R, Morera R, Villalonga R, Perna V, Macia I, Ferrer G (2006) Thoracic sympathicolysis for primary hyperhidrosis: a review of 918 procedures. Surg Endosc 20(4):598\u2013602. https:\/\/doi.org\/10.1007\/s00464-005-0557-z","journal-title":"Surg Endosc"},{"issue":"5","key":"2163_CR6","doi-asserted-by":"publisher","first-page":"1850","DOI":"10.1016\/j.athoracsur.2006.11.030","volume":"83","author":"DL Miller","year":"2007","unstructured":"Miller DL, Force SD (2007) Outpatient microthoracoscopic sympathectomy for palmar hyperhidrosis. Ann Thorac Surg 83(5):1850\u20131853. https:\/\/doi.org\/10.1016\/j.athoracsur.2006.11.030","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"2163_CR7","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.1007\/s00464-011-2022-5","volume":"26","author":"R Ramos","year":"2012","unstructured":"Ramos R, Ure\u00f1a A, Rivas F, Macia I, Rosado G, Peque\u00f1o S, Masuet C, Badia M, Miguel M, Delgado MA, Escobar I, Moya J (2012) Impact of T3 thoracoscopic sympathectomy on pupillary function: a cause of partial Horner\u2019s syndrome? Surg Endosc 26(4):1146\u20131152. https:\/\/doi.org\/10.1007\/s00464-011-2022-5","journal-title":"Surg Endosc"},{"issue":"2","key":"2163_CR8","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.athoracsur.2005.03.026","volume":"80","author":"K Kumagai","year":"2005","unstructured":"Kumagai K, Kawase H, Kawanishi M (2005) Health-related quality of life after thoracoscopic sympathectomy for palmar hyperhidrosis. Ann Thorac Surg 80(2):461\u2013466. https:\/\/doi.org\/10.1016\/j.athoracsur.2005.03.026","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"2163_CR9","doi-asserted-by":"publisher","DOI":"10.1111\/desc.12780","volume":"22","author":"F Zhang","year":"2019","unstructured":"Zhang F, Jaffe-Dax S, Wilson RC, Emberson LL (2019) Prediction in infants and adults: a pupillometry study. Dev Sci 22(4):e12780. https:\/\/doi.org\/10.1111\/desc.12780","journal-title":"Dev Sci"},{"issue":"4","key":"2163_CR10","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1007\/s11136-014-0825-2","volume":"24","author":"P Kamudoni","year":"2015","unstructured":"Kamudoni P, Mueller B, Salek MS (2015) The development and validation of a disease-specific quality of life measure in hyperhidrosis: the Hyperhidrosis Quality of Life Index (HidroQOL\u00a9). Qual Life Res 24(4):1017\u20131027. https:\/\/doi.org\/10.1007\/s11136-014-0825-2","journal-title":"Qual Life Res"},{"key":"2163_CR11","doi-asserted-by":"publisher","first-page":"268","DOI":"10.29399\/npa.27856","volume":"59","author":"S Kuyumcu Kavuncu","year":"2022","unstructured":"Kuyumcu Kavuncu S, Nal\u00e7ac\u0131o\u011flu P, G\u00fcne\u015f NH, \u00d6zkoyuncu D, Kara C (2022) A shift of the pupillary balance towards the parasymphathetic system in migraine patients with aura. Arch Neuropsych 59:268\u2013273. https:\/\/doi.org\/10.29399\/npa.27856","journal-title":"Arch Neuropsych"},{"issue":"10","key":"2163_CR12","doi-asserted-by":"publisher","first-page":"3575","DOI":"10.4103\/ijo.IJO_1254_22","volume":"70","author":"G Y\u0131ld\u0131r\u0131m Bi\u00e7er","year":"2022","unstructured":"Y\u0131ld\u0131r\u0131m Bi\u00e7er G, Zor KR, K\u00fc\u00e7\u00fck E (2022) Do static and dynamic pupillary parameters differ according to childhood, adulthood, and old age? A quantitative study in healthy volunteers. Indian J Ophthalmol 70(10):3575\u20133578. https:\/\/doi.org\/10.4103\/ijo.IJO_1254_22","journal-title":"Indian J Ophthalmol"},{"issue":"1","key":"2163_CR13","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1111\/j.1532-5415.2004.52030_7.x","volume":"52","author":"KN Fountoulakis","year":"2004","unstructured":"Fountoulakis KN, St Kaprinis G, Fotiou F (2004) Is there a role for pupillometry in the diagnostic approach of Alzheimer\u2019s disease? A review of the data. J Am Geriatr Soc 52(1):166\u2013168. https:\/\/doi.org\/10.1111\/j.1532-5415.2004.52030_7.x","journal-title":"J Am Geriatr Soc"},{"issue":"8","key":"2163_CR14","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1080\/08164622.2022.2145182","volume":"106","author":"GY Bi\u00e7er","year":"2023","unstructured":"Bi\u00e7er GY, Kurt A, Zor KR (2023) Efficacy of automatic pupillometry as a screening technique to detect autonomic dysfunction in bipolar disorder. Clin Exp Optom 106(8):896\u2013900. https:\/\/doi.org\/10.1080\/08164622.2022.2145182","journal-title":"Clin Exp Optom"},{"issue":"5","key":"2163_CR15","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1111\/cxo.12659","volume":"101","author":"K Tekin","year":"2018","unstructured":"Tekin K, Sekeroglu MA, Kiziltoprak H, Doguizi S, Inanc M, Yilmazbas P (2018) Static and dynamic pupillometry data of healthy individuals. Clin Exp Optom 101(5):659\u2013665. https:\/\/doi.org\/10.1111\/cxo.12659","journal-title":"Clin Exp Optom"},{"issue":"1","key":"2163_CR16","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1016\/j.athoracsur.2009.04.003","volume":"88","author":"V Ambrogi","year":"2009","unstructured":"Ambrogi V, Campione E, Mineo D, Patern\u00f2 EJ, Pompeo E, Mineo TC (2009) Bilateral thoracoscopic T2 to T3 sympathectomy versus botulinum injection in palmar hyperhidrosis. Ann Thorac Surg 88(1):238\u2013245. https:\/\/doi.org\/10.1016\/j.athoracsur.2009.04.003","journal-title":"Ann Thorac Surg"},{"issue":"8","key":"2163_CR17","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1007\/s11748-020-01376-5","volume":"68","author":"Y Wei","year":"2020","unstructured":"Wei Y, Xu ZD, Li H (2020) Quality of life after thoracic sympathectomy for palmar hyperhidrosis: a meta-analysis. Gen Thorac Cardiovasc Surg 68(8):746\u2013753. https:\/\/doi.org\/10.1007\/s11748-020-01376-5","journal-title":"Gen Thorac Cardiovasc Surg"},{"issue":"1","key":"2163_CR18","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1080\/07853890.2021.1953126","volume":"53","author":"G Felisberto Jr","year":"2021","unstructured":"Felisberto G Jr, Maria Cataneo AJ, Cristina CD (2021) Thoracic sympathectomy for the treatment of primary axillary hyperhidrosis: systematic review and proportional meta-analysis. Ann Med 53(1):1216\u20131226. https:\/\/doi.org\/10.1080\/07853890.2021.1953126","journal-title":"Ann Med"},{"issue":"5","key":"2163_CR19","doi-asserted-by":"publisher","first-page":"3585","DOI":"10.1007\/s00464-021-08684-8","volume":"36","author":"K Toolabi","year":"2022","unstructured":"Toolabi K, Parsaei R, Farid R, Zamanian A (2022) Endoscopic thoracic sympathotomy for primary hyperhidrosis: predictors of outcome over a 10-year period. Surg Endosc 36(5):3585\u20133591. https:\/\/doi.org\/10.1007\/s00464-021-08684-8","journal-title":"Surg Endosc"},{"issue":"19","key":"2163_CR20","doi-asserted-by":"publisher","DOI":"10.1016\/j.conctc.2020.100618","volume":"15","author":"NN Hamilton","year":"2020","unstructured":"Hamilton NN, Tedde ML, Wolosker N, Aguiar WWS, Ferreira HPDC, Oliveira HA, Lima AMR, Westphal FL, Oliveira MVB, Riuto FO, Pereira STLF, Rezende GC, Valero CEB, Pego-Fernandes PM (2020) A prospective controlled randomized multicenter study to evaluate the severity of compensatory sweating after one-stage bilateral thoracic sympathectomy versus unilateral thoracic sympathectomy in the dominant side. Contemp Clin Trials Commun 15(19):100618. https:\/\/doi.org\/10.1016\/j.conctc.2020.100618","journal-title":"Contemp Clin Trials Commun"},{"issue":"5","key":"2163_CR21","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1016\/j.athoracsur.2011.01.105","volume":"91","author":"RJ Cerfolio","year":"2011","unstructured":"Cerfolio RJ, De Campos JR, Bryant AS, Connery CP, Miller DL, DeCamp MM, McKenna RJ, Krasna MJ (2011) The society of thoracic surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg 91(5):1642\u20131648. https:\/\/doi.org\/10.1016\/j.athoracsur.2011.01.105","journal-title":"Ann Thorac Surg"},{"issue":"3","key":"2163_CR22","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1016\/j.jtcvs.2009.03.059","volume":"138","author":"DL Miller","year":"2009","unstructured":"Miller DL, Bryant AS, Force SD, Miller JI Jr (2009) Effect of sympathectomy level on the incidence of compensatory hyperhidrosis after sympathectomy for palmar hyperhidrosis. J Thorac Cardiovasc Surg 138(3):581\u2013585. https:\/\/doi.org\/10.1016\/j.jtcvs.2009.03.059","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"4","key":"2163_CR23","doi-asserted-by":"publisher","first-page":"1748","DOI":"10.1016\/j.jtcvs.2018.05.084","volume":"156","author":"DBD Leiderman","year":"2018","unstructured":"Leiderman DBD, de Milanez Campos JR, Kauffman P, Tedde ML, Yazbek G, Teivelis MP, Wolosker N (2018) The relation between age and outcomes of thoracic sympathectomy for hyperhidrosis: the older the better. J Thorac Cardiovasc Surg 156(4):1748\u20131756. https:\/\/doi.org\/10.1016\/j.jtcvs.2018.05.084","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2163_CR24","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.avsg.2019.04.024","volume":"65","author":"CB Faustino","year":"2020","unstructured":"Faustino CB, de Milanez Campos JR, Kauffman P, Leiderman DD, Tedde M, Cucato G, Fernandes PP, Le\u00e3o PP, Wolosker N (2020) Analysis of the results of videotoracoscopic sympathectomy in the treatment of hyperhidrosis in patients 40 years or older. Ann Vasc Surg 65:107\u2013112. https:\/\/doi.org\/10.1016\/j.avsg.2019.04.024","journal-title":"Ann Vasc Surg"},{"issue":"2","key":"2163_CR25","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1007\/s12055-018-0769-1","volume":"35","author":"M Kara","year":"2019","unstructured":"Kara M, Kose S, Cayirci CE, Koksal A (2019) Can we predict the compensatory hyperhidrosis following a thoracic sympathectomy? Indian J Thorac Cardiovasc Surg 35(2):190\u2013195. https:\/\/doi.org\/10.1007\/s12055-018-0769-1","journal-title":"Indian J Thorac Cardiovasc Surg"},{"issue":"3","key":"2163_CR26","first-page":"161","volume":"90","author":"CC Lin","year":"2001","unstructured":"Lin CC, Telaranta T (2001) Lin-Telaranta classification: the importance of different procedures for different indications in sympathetic surgery. Ann Chir Gynaecol 90(3):161\u2013166","journal-title":"Ann Chir Gynaecol"},{"issue":"8","key":"2163_CR27","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1590\/S1807-59322009000800006","volume":"64","author":"G Yazbek","year":"2009","unstructured":"Yazbek G, Wolosker N, Kauffman P, Campos JR, Puech-Le\u00e3o P, Jatene FB (2009) Twenty months of evolution following sympathectomy on patients with palmar hyperhidrosis: sympathectomy at the T3 level is better than at the T2 level. Clinics (Sao Paulo) 64(8):743\u2013749. https:\/\/doi.org\/10.1590\/S1807-59322009000800006","journal-title":"Clinics (Sao Paulo)"},{"issue":"11","key":"2163_CR28","doi-asserted-by":"publisher","first-page":"2343","DOI":"10.1007\/s00268-008-9716-4","volume":"32","author":"D Kopelman","year":"2008","unstructured":"Kopelman D, Hashmonai M (2008) The correlation between the method of sympathetic ablation for palmar hyperhidrosis and the occurrence of compensatory hyperhidrosis: a review. World J Surg 32(11):2343\u20132356. https:\/\/doi.org\/10.1007\/s00268-008-9716-4","journal-title":"World J Surg"},{"issue":"10","key":"2163_CR29","doi-asserted-by":"publisher","first-page":"1768","DOI":"10.1007\/s00464-007-9241-9","volume":"21","author":"AN Katara","year":"2007","unstructured":"Katara AN, Domino JP, Cheah WK, So JB, Ning C, Lomanto D (2007) Comparing T2 and T2\u2013T3 ablation in thoracoscopic sympathectomy for palmar hyperhidrosis: a randomized control trial. Surg Endosc 21(10):1768\u20131771. https:\/\/doi.org\/10.1007\/s00464-007-9241-9","journal-title":"Surg Endosc"},{"issue":"3","key":"2163_CR30","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1007\/s11748-019-01210-7","volume":"68","author":"MV Dogru","year":"2020","unstructured":"Dogru MV, Sezen CB, Girgin O, Cansever L, Kocaturk CI, Metin M, Dincer SI (2020) Is there any relationship between quality of life and the level of sympathectomy in primary palmar hyperhidrosis? Single-center experience Gen Thorac Cardiovasc Surg 68(3):273\u2013279. https:\/\/doi.org\/10.1007\/s11748-019-01210-7","journal-title":"Single-center experience Gen Thorac Cardiovasc Surg"},{"issue":"4","key":"2163_CR31","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1016\/j.jtcvs.2013.12.016","volume":"147","author":"AS Bryant","year":"2014","unstructured":"Bryant AS, Cerfolio RJ (2014) Satisfaction and compensatory hyperhidrosis rates 5 years and longer after video-assisted thoracoscopic sympathotomy for hyperhidrosis. J Thorac Cardiovasc Surg 147(4):1160-1163.e1. https:\/\/doi.org\/10.1016\/j.jtcvs.2013.12.016","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Updates in Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13304-025-02163-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13304-025-02163-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13304-025-02163-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T21:03:56Z","timestamp":1771275836000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13304-025-02163-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["2163"],"URL":"https:\/\/doi.org\/10.1007\/s13304-025-02163-8","relation":{},"ISSN":["2038-131X","2038-3312"],"issn-type":[{"value":"2038-131X","type":"print"},{"value":"2038-3312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]},"assertion":[{"value":"30 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"There is no conflict of interest for all authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Local ethical committee approval (AE\u015eH-EK1-2023-401) was taken from Ankara Etlik City Hospital Ethical Commitee before the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Research involving human participants and informed consent was obtained from all patients and\/or their legal guardians(s).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals and Informed consent"}}]}}