从婴儿期起就吃"正确食物"的儿童不会出现扁桃体肿大、腺样体肥大或阑尾炎;配方奶和婴儿米粉才是儿童需要做这些手术的原因。
原始表述
موضوع بقى الالبان الصناعي والسريلاك وكل ده زباله عشان كده العيال كلها في سن خمس سنين يجيله لحميه ولوز وزايده وشيل يا معلم
按来源为原话. 译文由本项目提供;以阿拉伯语原文为准。
译文
从婴儿期起就吃"正确食物"的儿童不会出现扁桃体肿大、腺样体肥大或阑尾炎;配方奶和婴儿米粉才是儿童需要做这些手术的原因。
出处
- 来源状态
- 视频转录文本(本人原话)
- 归属
- Elawady (machine transcript)
- 视频
- Dr Diaa Al Awady د ضياء العوضي is live! انتاج الطاقة مرتبط بانتاج الجذور الحرة (打开来源)
- 发布日期
- 2025年9月14日
- 时间戳
- 0:26:00 (在原视频 YouTube 自动字幕轨中的位置;可确认该内容出现的位置,但不能确认说话人是谁)
- 归属的不确定性
- Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
- 所声称的机制
Wrong food causes lymphoid tissue disease.
- 所声称的健康影响
Tonsil/adenoid hypertrophy, appendicitis.
- 涉及人群
Children
- Elawady 设定的地域限制
none found
来源版本存在差异
- 来源状态
- 视频转录文本(本人原话)
- 归属
- Elawady (machine transcript)
- 视频
- Dr Diaa Al Awady د ضياء العوضي is live! الدراسات اللي ينشرها لمعرفة مدي تخبط الطب حتي ٢٠٢٥ (打开来源)
- 发布日期
- 2025年7月26日
- 时间戳
- 无(转录文本不含时间信息)
- 归属的不确定性
- Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
科学评估
不明确 / 证据不足 – 现有数据无法支持任何方向的评估。
证据确定性: 极低 – 任何评估都非常不确定。
1. 说法是什么?
Diet from infancy prevents these diseases; formula causes them.
2. 哪些内容可证实是正确的?
Breastfeeding is recommended and protects against childhood infections (I-INTC-14). A small study found that children breastfed for longer had appendicitis less often than their siblings (I-INTC-12).
3. 哪些内容是错误或夸大的?
The claim that 'all children' develop enlarged tonsils, adenoids or appendicitis because of formula and infant cereals is not supported. In one large clinical study of referred snoring children, breastfeeding was associated with sleep apnoea, a main reason for adenotonsillectomy (I-INTC-13); that study compared breastfeeding with no breastfeeding (not formula or infant cereals specifically), measured sleep apnoea rather than tonsil or adenoid size or surgery, and used a highly selected sample, so it limits the claim but does not show that formula does not cause adenotonsillar hypertrophy.
4. 哪些内容仍不明确?
Whether infant feeding has a causal effect on appendicitis or adenotonsillar hypertrophy is unknown; the available studies are small or confounded, and no study of infant cereals was found.
5. 哪些研究支持该说法?
I-INTC-12 (weak association between breastfeeding and less appendicitis); I-INTC-14 (fewer infections with breastfeeding; surgery not addressed).
6. 哪些研究与该说法相矛盾?
I-INTC-13 (breastfeeding associated with OSAS in a clinical sample, likely confounded); I-ORG-06 (tonsillectomy indications based on infection frequency and documented sleep apnoea).
7. 对德国和欧洲而言情况如何?
Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).
8. 关于埃及的已知情况是什么?
No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.
9. 合理的实际结论是什么?
无法得出结论;这一说法未经证实。
评估详情
- 证据确定性的依据
A targeted search found only indirect or weak evidence. One small sibling case-control study associated longer breastfeeding with less appendicitis (I-INTC-12). Breastfeeding protects against childhood infections, but surgical outcomes are not addressed (I-INTC-14). In a large clinical sample, breastfeeding (not formula) was associated with childhood sleep apnoea, a main indication for adenotonsillectomy, probably due to confounding (I-INTC-13). Indications for tonsillectomy are defined by infection frequency and documented sleep apnoea (I-ORG-06). No study supports the claim that formula or infant cereals are 'the reason' children need these operations.
- 来源质量
Assertion without data.
- 地区可推广性
n/a
- 个体例外情况
n/a
- 说法的地域范围
- 普遍性(生物学/医学)
- 最近审核
- 2026年10月26日 初步
科学证据详解
缺乏高质量证据支持 – 没有良好证据支持该说法;但仅凭这一点并不能证明它是错误的。
研究问题: In infants and children, does formula feeding or infant cereals (versus 'proper food' such as breastfeeding) cause adenotonsillar hypertrophy or appendicitis requiring surgery?
研究问题详解 (PECO)
- 人群
- Infants and children
- 干预或暴露
- Formula milk and infant cereals
- 对照
- Breastfeeding / 'proper food'
- 地域范围
- universal biology; infant feeding practices vary by country
- 结局指标
- Adenotonsillar hypertrophy
- Snoring/OSA
- Appendicitis
- Adenotonsillectomy or appendectomy
研究结果按作者报告呈现。我们的评估见下文。
哪些证据支持该说法?
Breastfeeding and appendicitis
Small sibling case-control study: longer breastfeeding associated with less appendicitis.
- 实际结果
- Effect sizes not given in abstract.
- 方法学质量
- low (small case-control)
- 相关性
- indirect: breastfeeding vs not, not formula per se
- 局限
- Recall bias; small.
Breastfeeding and snoring in children
Storari M et al.. Eur J Paediatr Dent 2021 · PMID 35034467 · DOI 10.23804/ejpd.2021.22.04.10 系统综述已核查摘要新增Systematic review: breastfeeding associated with less habitual snoring.
- 实际结果
- No pooled estimate in abstract.
- 方法学质量
- low (narrative SR of observational studies)
- 相关性
- indirect: snoring, not surgery
- 局限
- Confounding; no meta-analysis.
哪些证据不支持该说法?
Breastfeeding and adenoid size in preschool children
Breastfeeding duration was not associated with adenoid size in 145 preschool children.
- 实际结果
- No effect on adenoid size; less snoring with >= 3 months.
- 方法学质量
- low (small case-control)
- 相关性
- direct for adenoid size
- 局限
- Small clinic sample.
What is linked to sleep apnoea in children
Xu Z et al.. J Otolaryngol Head Neck Surg 2020 · PMID 32131901 · DOI 10.1186/s40463-020-0404-1 横断面研究全文,含结构化偏倚风险评估In a large referred sample, breastfeeding was associated with more OSAS.
- 实际结果
- OR 1.72 (1.26-2.36).
- 方法学质量
- low (cross-sectional, confounded)
- 相关性
- indirect
- 局限
- Selected sample, likely confounded.
总体证据说明了什么?
基于上述研究的编辑评估——其本身并非研究结果。
哪种观点有更好的证据支持?
Breastfeeding has established benefits (fewer infections) and may be associated with less snoring, but no study shows that formula or infant cereals cause enlarged tonsils/adenoids or appendicitis, and the absolute statement that well-fed children 'do not develop' these conditions is unsupported.
为什么有些研究权重更大
Only small or confounded observational studies exist; none tested formula or infant cereals directly; no study measured surgery rates.
因果关系是否已确立? 尚未确立 No direct data; observational findings conflict.
仍存在的不确定性
Whether infant feeding influences adenotonsillar growth or appendicitis at all.
合理的结论
Unproven; breastfeeding is recommended for other reasons, and children with sleep apnoea, recurrent severe throat infection or suspected appendicitis need medical assessment regardless of diet.
为什么研究结果看起来互相矛盾?
Storari 2021 (less snoring) and Xu 2020 (more OSAS with breastfeeding) answer different questions in different samples (general children vs referred clinic patients); snoring is not the same as adenoid size, which Zwierz 2023 found unrelated to breastfeeding. Pitesa 2025 concerns adult/population diet and fibre, not infant feeding.
这是否取决于国家?
- 一般生物学效应
- Adenotonsillar growth in early childhood is physiological; appendicitis occurs in all feeding groups.
- 饮食习惯
- Infant feeding practices differ between Egypt and Europe, but no data link them to these operations.
- 食品原产地
- Not applicable.
- 污染物
- Not applicable.
- 本国生产条件
- Not applicable.
- 法律规则
- Not applicable.
- 实际监测数据
- No Egypt-specific monitoring data identified.
足以改变结论的地区差异没有可靠数据支持。
统计复核
- Pooled fibre difference significance and heterogeneity – MD -4.53 g (95% CI -10.98 to 1.94) crosses zero; I2 98.3% - no reliable pooled effect 无法根据已发表数据重新计算
总体证据的确定性(GRADE,简化版)
- 主要结局
- Adenotonsillectomy/appendectomy by infant feeding type
- 起始等级
- 低(观察性研究)
- 降级理由
- risk of bias
- indirectness (no study of formula/infant cereals or of surgery)
- inconsistency
- 结果
- 极低
由单名审查者参照 GRADE 方法进行的简化评估;并非正式的 GRADE 专家组评估。GRADE 评价的是针对某一结局的整体证据,而非单项研究。
已核查的临床指南和官方声明
- AAO-HNS Foundation: Clinical Practice Guideline: Tonsillectomy in Children (Update) (2019) · 原始文献
Strong recommendation for watchful waiting for recurrent throat infection below 7/5/3 episodes per year in the past 1/2/3 years; modifying factors may favour surgery; polysomnography before tonsillectomy for obstructive sleep-disordered breathing in high-risk children; tonsillectomy is a treatment option for obstructive sleep-disordered breathing with tonsillar hypertrophy (abstract key action statements; registered as I-ORG-06).
检索策略
本次审查的文献检索记录(检索式采用原数据库语法)。
| 数据库 | 日期 | 检索式 | 检索目标 | 命中数 | 纳入数 |
|---|---|---|---|---|---|
| Europe PMC | 2026年10月26日 | (breastfeeding OR "breast feeding" OR "breast-feeding" OR "formula feeding") AND (TITLE:appendicitis) | 支持性证据 | 40 | |
| Europe PMC | 2026年10月26日 | (breastfeeding OR "breast feeding" OR "breast-feeding" OR "formula feeding" OR "infant feeding") AND (TITLE:tonsillectomy OR TITLE:adenotonsillectomy OR TITLE:adenoidectomy OR TITLE:"adenoid hypertrophy" OR TITLE:"adenotonsillar hypertrophy") | 支持性证据 | 36 | |
| Europe PMC | 2026年10月26日 | (breastfeeding OR "breast feeding") AND (TITLE:"sleep-disordered breathing" OR TITLE:snoring OR TITLE:"sleep apnea") AND children AND (TITLE:"meta-analysis" OR TITLE:"systematic review" OR cohort) | 双向 | 47 | |
| PubMed | 2026年10月26日 | (breast feeding[tiab] OR breastfeeding[tiab]) AND appendicitis[tiab] AND (meta-analysis OR cohort) | 支持性证据 | 1 | |
| Europe PMC | 2026年10月26日 | (TITLE:appendicitis) AND (diet OR "dietary fibre" OR "dietary fiber" OR "infant formula") AND (cohort OR "case-control") | 双向 | 149 | |
| Europe PMC | 2026年10月26日 | (TITLE:"infant formula" OR TITLE:"formula feeding" OR TITLE:"formula-fed") AND (TITLE:tonsil OR TITLE:adenoid OR TITLE:appendicitis OR TITLE:"sleep apnea" OR TITLE:snoring) | 支持性证据 | 0 | |
| PubMed | 2026年10月26日 | (adenotonsillar hypertrophy[tiab] OR adenoid hypertrophy[tiab]) AND risk factors[tiab] AND children[tiab] AND (breast* OR feeding OR diet*) | 反对性证据 | 14 | |
| PubMed | 2026年10月26日 | (appendicitis[ti]) AND (breastfed OR breastfeeding OR breast-feeding) AND (risk[tiab]) | 支持性证据 | 1 |
待解决的问题
Prospective birth cohorts with surgery outcomes by feeding type.
核查深度如何?
7 项相关研究:1 项核查了全文(其中 1 项进行了结构化偏倚风险评估),6 项基于摘要核查,0 项仅核查了文献信息。 尚未进行由两名独立审查者完成的正式评估,也尚未进行独立的人类专家审核。
最近一次科学审核: 2026年10月26日
评定结论的变更历史
- 2026年10月25日 · 第 1 阶段 · 初始评估: 不明确 / 证据不足 (极低)
- 2026年10月26日 · 第 4 阶段(系统证据审查) · 在扩展证据后重新审查;评定结论不变: 不明确 / 证据不足 (极低)
Unchanged (UNCLEAR, very low). New studies are small and indirect and point in different directions; no direct evidence on formula, infant cereals or surgery rates was found.
新来源: I-ORG-120 I-ORG-119 I-ORG-121
通俗解释
Elawady 说,配方奶和婴儿米粉是儿童出现腺样体肥大、扁桃体肿大和阑尾炎的原因。母乳喂养确实有益处,例如感染更少,一项小型研究还将较长时间的母乳喂养与较少的阑尾炎联系在一起。但没有研究表明配方奶是儿童需要做这些手术的原因,一项大型研究甚至发现母乳喂养的儿童睡眠呼吸暂停更多,这很可能是由于其他原因。这一观点仍未经证实。
与该说法相关的研究
支持该说法的研究 (0)
该组中没有研究。
与该说法相矛盾或限制该说法的研究 (3)
-
What is linked to sleep apnoea in children
Xu Z et al.. J Otolaryngol Head Neck Surg 2020 · PMID 32131901 · DOI 10.1186/s40463-020-0404-1横断面研究独立交叉核查全文,含结构化偏倚风险评估Enlarged tonsils and adenoids, obesity and male sex were linked to sleep apnoea; breastfeeding was too, probably due to other factors.
Breastfeeding, not formula, was associated with OSAS in this sample (likely confounded).
该研究是否支持这一具体说法? 否 · 方法学质量: 低 · 证据确定性:见该说法的总体评估
研究通俗解读
- 研究人员想了解什么?
Identify OSAS risk factors in children
- 研究是如何开展的?
Cross-sectional with sleep studies
- 研究了多少人、动物或样本?
1578 children
- 实际发现了什么?
Adenotonsillar hypertrophy, obesity, male sex, breastfeeding
- 观察到的效应有多大?
not reported
- 研究结果对日常生活意味着什么?
Formula feeding was not identified as the cause of enlarged tonsils.
- 该研究有哪些局限?
Confounding; clinic sample
- 它对 Elawady 的具体说法说明了什么?
Does not support the formula claim
- 研究结果是否适用于德国和欧洲?
Low
- 从该研究中明确不能得出什么结论?
Causation
-
US guideline on tonsil surgery in children
Mitchell RB et al.. Otolaryngol Head Neck Surg 2019 · PMID 30798778 · DOI 10.1177/0194599818801757指南 / 立场声明独立交叉核查已核查摘要Watchful waiting is recommended unless infections are very frequent; surgery is recommended for documented sleep apnea.
该研究是否支持这一具体说法? 部分支持 · 方法学质量: 高 · 证据确定性:见该说法的总体评估
研究通俗解读
- 研究人员想了解什么?
Indications
- 研究是如何开展的?
Guideline
- 研究了多少人、动物或样本?
n/a
- 实际发现了什么?
Clear thresholds
- 观察到的效应有多大?
n/a
- 研究结果对日常生活意味着什么?
Not every child needs surgery; some clearly do
- 该研究有哪些局限?
US
- 它对 Elawady 的具体说法说明了什么?
Partly aligns
- 研究结果是否适用于德国和欧洲?
Similar principles
- 从该研究中明确不能得出什么结论?
Individual decisions
-
Breastfeeding and adenoid size in preschool children
Zwierz A et al.. J Clin Med 2023 · PMID 38137751 · DOI 10.3390/jcm12247683病例对照研究独立交叉核查已核查摘要Longer breastfeeding was linked to less snoring and fewer ear infections, but not to smaller adenoids.
Breastfeeding duration was not associated with adenoid size.
该研究是否支持这一具体说法? 否 · 方法学质量: 低 · 证据确定性:见该说法的总体评估
研究通俗解读
- 研究人员想了解什么?
Relate breastfeeding duration to adenoid size and snoring
- 研究是如何开展的?
Case-control study
- 研究了多少人、动物或样本?
145 Polish children aged 3-5
- 实际发现了什么?
No effect on adenoid size; less snoring and AOM
- 观察到的效应有多大?
Snoring risk >4-fold with <3 months
- 研究结果对日常生活意味着什么?
Breastfeeding has benefits but does not seem to prevent adenoid enlargement
- 该研究有哪些局限?
Small, recall bias
- 它对 Elawady 的具体说法说明了什么?
Contradicts the claim
- 研究结果是否适用于德国和欧洲?
European
- 从该研究中明确不能得出什么结论?
Cannot prove causation
该组中没有被标记为关键研究的研究。
结果不一或不明确的研究 (4)
-
Breastfeeding and appendicitis
Alves JG et al.. Trop Doct 2008 · PMID 18820196 · DOI 10.1258/td.2008.070404病例对照研究独立交叉核查已核查摘要Children breastfed for longer had appendicitis less often than their siblings in one small study.
Weak association between less breastfeeding and appendicitis; not causation.
该研究是否支持这一具体说法? 部分支持 · 方法学质量: 低 · 证据确定性:见该说法的总体评估
研究通俗解读
- 研究人员想了解什么?
Test breastfeeding vs appendicitis
- 研究是如何开展的?
Sibling case-control
- 研究了多少人、动物或样本?
200 cases, 200 siblings
- 实际发现了什么?
Breastfeeding associated with protection
- 观察到的效应有多大?
not reported in abstract
- 研究结果对日常生活意味着什么?
A possible link, not proof.
- 该研究有哪些局限?
Small; recall; no numbers
- 它对 Elawady 的具体说法说明了什么?
Weak partial support
- 研究结果是否适用于德国和欧洲?
Low
- 从该研究中明确不能得出什么结论?
Causation; tonsil/adenoid outcomes
-
Benefits of breastfeeding
Victora CG et al.. Lancet 2016 · PMID 26869575 · DOI 10.1016/S0140-6736(15)01024-7Meta分析独立交叉核查已核查摘要Breastfeeding protects children against infections and has other benefits; it is not shown here to prevent tonsil or appendix surgery.
Breastfeeding protects against infections, but surgical outcomes are not addressed.
该研究是否支持这一具体说法? 部分支持 · 方法学质量: 高 · 证据确定性:见该说法的总体评估
研究通俗解读
- 研究人员想了解什么?
Summarise effects of breastfeeding
- 研究是如何开展的?
Systematic reviews and meta-analyses
- 研究了多少人、动物或样本?
Global
- 实际发现了什么?
Fewer infections, other benefits
- 观察到的效应有多大?
823,000 deaths preventable per year (modelled)
- 研究结果对日常生活意味着什么?
Breastfeeding is beneficial; formula is not shown to cause surgery.
- 该研究有哪些局限?
Observational evidence; surgery outcomes not covered
- 它对 Elawady 的具体说法说明了什么?
Supports only the general importance of infant feeding
- 研究结果是否适用于德国和欧洲?
High
- 从该研究中明确不能得出什么结论?
Tonsil/adenoid/appendix outcomes
-
Breastfeeding and snoring in children
Storari M et al.. Eur J Paediatr Dent 2021 · PMID 35034467 · DOI 10.23804/ejpd.2021.22.04.10系统综述独立交叉核查已核查摘要A review suggests breastfed children snore less, but the studies are observational and no numbers were pooled.
Breastfeeding linked to less snoring (weak); no data on surgery or on formula/infant cereals as a cause.
该研究是否支持这一具体说法? 部分支持 · 方法学质量: 低 · 证据确定性:见该说法的总体评估
研究通俗解读
- 研究人员想了解什么?
Review breastfeeding and childhood sleep-disordered breathing
- 研究是如何开展的?
Systematic review
- 研究了多少人、动物或样本?
Not stated
- 实际发现了什么?
Breastfeeding linked to less habitual snoring
- 观察到的效应有多大?
Not reported
- 研究结果对日常生活意味着什么?
Breastfeeding has benefits; it is not proven to prevent tonsil surgery
- 该研究有哪些局限?
Observational, no meta-analysis
- 它对 Elawady 的具体说法说明了什么?
Weak partial support; does not show formula causes surgery
- 研究结果是否适用于德国和欧洲?
Moderate
- 从该研究中明确不能得出什么结论?
Cannot show causation
-
Diet and appendicitis
Pitesa R et al.. World J Surg 2025 · PMID 41265933 · DOI 10.1002/wjs.70166Meta分析独立交叉核查已核查摘要Low-fibre western diets may be linked to appendicitis, but the evidence is weak and inconsistent.
Weak signal that low-fibre western diets are linked to appendicitis; nothing on formula or infant cereals.
该研究是否支持这一具体说法? 部分支持 · 方法学质量: 低 · 证据确定性:见该说法的总体评估
研究通俗解读
- 研究人员想了解什么?
Review diet and appendicitis risk
- 研究是如何开展的?
Systematic review and meta-analysis
- 研究了多少人、动物或样本?
21 studies
- 实际发现了什么?
Possible link with low fibre; not statistically clear
- 观察到的效应有多大?
MD -4.53 g fibre (not significant)
- 研究结果对日常生活意味着什么?
Diet might matter but is not proven
- 该研究有哪些局限?
High risk of bias, heterogeneity
- 它对 Elawady 的具体说法说明了什么?
Weak indirect support; not about infant formula
- 研究结果是否适用于德国和欧洲?
Moderate
- 从该研究中明确不能得出什么结论?
Cannot show that diet prevents appendicitis
该组中没有被标记为关键研究的研究。
地区背景
德国 / 欧盟
Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).
埃及
No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.
- Antimicrobial use in food animals and antibiotic growth promoters
- Hormones in poultry, meat, milk and farmed fish
- Dioxins, PCBs and PFAS in eggs and other animal foods
- Aflatoxin M1 in milk and dairy products
- Drinking water quality
- Import controls and the meaning of RASFF notifications for Egyptian products
在我的国家适用什么?
一般科学评估
不明确 / 证据不足 未经证实:母乳喂养是有益的,但没有证据表明配方奶会导致需要做扁桃体、腺样体或阑尾手术。
以下食品安全领域与该说法相关:
- 兽药与抗生素
- 激素类促生长剂
- 污染物(重金属、PFAS、PCB、二噁英、硝酸盐)
- 真菌毒素(霉菌毒素)
- 监管、进口、召回、标签
乳制品
选择一个国家,查看针对该国已核查的信息。
局限:法律规则描述的是允许什么,而不是每一种食品实际含有什么。检测数据来自样本,只有结合其方法细节才有意义。
参考文献
- Risk factors of obstructive sleep apnea syndrome in children.. Xu Z et al.. J Otolaryngol Head Neck Surg 2020 · PMID 32131901 · DOI 10.1186/s40463-020-0404-1
- Clinical Practice Guideline: Tonsillectomy in Children (Update).. Mitchell RB et al.. Otolaryngol Head Neck Surg 2019 · PMID 30798778 · DOI 10.1177/0194599818801757
- Impact of Breastfeeding Duration on Adenoid Hypertrophy, Snoring and Acute Otitis Media: A Case-Control Study in Preschool Children.. Zwierz A et al.. J Clin Med 2023 · PMID 38137751 · DOI 10.3390/jcm12247683
- Does breast feeding provide protection against acute appendicitis? A case-control study.. Alves JG et al.. Trop Doct 2008 · PMID 18820196 · DOI 10.1258/td.2008.070404
- Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.. Victora CG et al.. Lancet 2016 · PMID 26869575 · DOI 10.1016/S0140-6736(15)01024-7
- Breastfeeding and sleep-disordered breathing in children: systematic review and proposal of underlying interaction models.. Storari M et al.. Eur J Paediatr Dent 2021 · PMID 35034467 · DOI 10.23804/ejpd.2021.22.04.10
- Revisiting Diet and Appendicitis: A Systematic Review and Meta-Analysis.. Pitesa R et al.. World J Surg 2025 · PMID 41265933 · DOI 10.1002/wjs.70166