1
|
Surgical management of female genital mutilation-related morbidity: A scoping review. J Plast Reconstr Aesthet Surg 2021; 74:2467-2478. [PMID: 34219039 DOI: 10.1016/j.bjps.2021.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/24/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Over 200 million women and girls worldwide have suffered from the partial to total removal of external female genitalia for nonmedical purposes, referred to as female genital mutilation (FGM). Survivors of FGM may develop debilitating physical and psychological long-term sequelae. This is the first study to examine the scope of the extant surgical literature on the management of FGM-related morbidity. METHODS A systematic scoping review of five major research citation databases was conducted. RESULTS A total of 190 articles from 29 countries met the inclusion criteria. The majority (76%) were primary source articles and from obstetrics and gynecology literature (71%). Reported interventions for FGM-related morbidity were defibulation, cyst excision, clitoral and vulvar reconstruction, urological reconstruction, peripartum procedures, labial adhesion release, and reinfibulation. CONCLUSIONS Surgery for FGM complications spans multiple specialties, which suggests multidisciplinary collaboration benefit. Plastic and reconstructive surgeons have a clear role in the multidisciplinary care team for these patients. This scoping review identified a paucity of high-quality evidence with respect to functional quality of life outcomes and long-term follow-up.
Collapse
|
2
|
Kibar Ozturk M, Zindanci İ, Zemheri E, Çakır C. The largest epidermal cyst with vitiligo lesions following female genital mutilation: a case report and literature review. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2018. [DOI: 10.15570/actaapa.2018.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
3
|
Berg RC, Taraldsen S, Said MA, Sørbye IK, Vangen S. Reasons for and Experiences With Surgical Interventions for Female Genital Mutilation/Cutting (FGM/C): A Systematic Review. J Sex Med 2017; 14:977-990. [PMID: 28666656 DOI: 10.1016/j.jsxm.2017.05.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 05/19/2017] [Accepted: 05/31/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Because female genital mutilation/cutting (FGM/C) leads to changes in normal genital anatomy and functionality, women are increasingly seeking surgical interventions for their FGM/C-related concerns. AIM To conduct a systematic review of empirical quantitative and qualitative research on interventions for women with FGM/C-related complications. METHODS We conducted systematic searches up to May 2016 in 16 databases to obtain references from different disciplines. We accepted all study designs consisting of girls and women who had been subjected to FGM/C and that examined a reparative intervention for a FGM/C-related concern. We screened the titles, abstracts, and full texts of retrieved records for relevance. Then, we assessed the methodologic quality of the included studies and extracted and synthesized the study data. OUTCOMES All outcomes were included. RESULTS Of 3,726 retrieved references, 71 studies including 7,291 women were eligible for inclusion. We identified three different types of surgical intervention: defibulation or surgical separation of fused labia, excision of a cyst with or without some form of reconstruction, and clitoral or clitoral-labial reconstruction. Reasons for seeking surgical interventions consisted of functional complaints, sexual aspirations, esthetic aspirations, and identity recovery. The most common reasons for defibulation were a desire for improved sexual pleasure, vaginal appearance, and functioning. For cyst excision, cystic swelling was the main reason for seeking excision; for reconstruction, the main reason was to recover identity. Data on women's experiences with a surgical intervention are sparse, but we found that women reported easier births after defibulation. Our findings also suggested that most women were satisfied with defibulation (overall satisfaction = 50-100%), typically because of improvements in their sexual lives. Conversely, the results suggested that defibulation had low social acceptance and that the procedure created distress in some women who disliked the new appearance of their genitalia. Most women were satisfied with clitoral reconstruction, but approximately one third were dissatisfied with or perceived a worsening in the esthetic look. CLINICAL TRANSLATION The information health care professionals give to women who seek surgical interventions for FGM/C should detail the intervention options available and what women can realistically expect from such interventions. STRENGTHS AND LIMITATIONS The systematic review was conducted in accordance with guidelines, but there is a slight possibility that studies were missed. CONCLUSION There are some data on women's motivations for surgery for FGM/C-related concerns, but little is known about whether women are satisfied with the surgery, and experiences appear mixed. Berg RC, Taraldsen S, Said MA, et al. Reasons for and Experiences With Surgical Interventions for Female Genital Mutilation/Cutting (FGM/C): A Systematic Review. J Sex Med 2017;14:977-990.
Collapse
Affiliation(s)
- Rigmor C Berg
- Norwegian Institute of Public Health, Oslo, Norway; University of Tromso, Tromso, Norway.
| | - Sølvi Taraldsen
- Norwegian National Advisory Unit on Women's Health, Division of Gynecology and Obstetrics, Oslo University Hospital HF Rikshospitalet, Oslo, Norway
| | - Maryan A Said
- Norwegian National Advisory Unit on Women's Health, Division of Gynecology and Obstetrics, Oslo University Hospital HF Rikshospitalet, Oslo, Norway; Oslo University Hospital Ullevål Hospital, Oslo, Norway
| | - Ingvil Krarup Sørbye
- Norwegian National Advisory Unit on Women's Health, Division of Gynecology and Obstetrics, Oslo University Hospital HF Rikshospitalet, Oslo, Norway
| | - Siri Vangen
- Norwegian National Advisory Unit on Women's Health, Division of Gynecology and Obstetrics, Oslo University Hospital HF Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
4
|
Odukogbe ATA, Afolabi BB, Bello OO, Adeyanju AS. Female genital mutilation/cutting in Africa. Transl Androl Urol 2017; 6:138-148. [PMID: 28540220 PMCID: PMC5422681 DOI: 10.21037/tau.2016.12.01] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Female genital mutilation/cutting (FGM/C) is a traditional practice in which the external female genitalia is partially or totally incised or excised for a non-therapeutic reason, usually without the consent of the individual. FGM/C is common in Africa with varying prevalence in different countries, though the incidence is reducing because it is considered a human rights issue with tremendous advocacy for its elimination by mainly nongovernmental organizations. It is mainly underreported in many countries in Africa especially where it has been declared illegal. FGM/C is often performed by a nonmedical practitioner with the aim of fulfilling religious or cultural rites and sometimes for economic benefits with the resultant acute, intermediate and late complications. It is sometimes performed by medical practitioners when it is speciously believed that its medicalization reduces the complications associated with the practice. The sensitivity of FGM/C is amplified when compared to male circumcision and voluntary alterations of the female external genitalia like piercing and tattooing as similar practices. The magnitude of the physical and psychosocial consequences of FGM/C outweighs the presumed benefits of the procedures highlighting the need for improvement of the multiple preventive measures by all the stakeholders and in all the sectors.
Collapse
Affiliation(s)
- Akin-Tunde A Odukogbe
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Bosede B Afolabi
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos and Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwasomidoyin O Bello
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Ayodeji S Adeyanju
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria
| |
Collapse
|
5
|
Abayomi O, Chibuzor MT, Okusanya BO, Esu E, Odey E, Meremikwu MM. Supportive psychotherapy or client education alongside surgical procedures to correct complications of female genital mutilation: A systematic review. Int J Gynaecol Obstet 2017; 136 Suppl 1:51-55. [DOI: 10.1002/ijgo.12042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Olukayode Abayomi
- Department of Mental health; Ladoke Akintola University Teaching Hospital; Ogbomoso Oyo Nigeria
| | - Moriam T. Chibuzor
- Cochrane Nigeria; Institute of Tropical Diseases Research and Prevention Calabar; University of Calabar Teaching Hospital; Calabar Nigeria
| | - Babasola O. Okusanya
- Experimental and Maternal Medicine Unit; Department of Obstetrics and Gynecology; Faculty of Clinical Sciences; College of Medicine; University of Lagos; Idi-Araba Lagos Nigeria
| | - Ekpereonne Esu
- Department of Public Health; University of Calabar; Calabar Nigeria
| | - Edward Odey
- Department of Social Science Education; Faculty of Education; University of Calabar; Calabar Nigeria
| | - Martin M. Meremikwu
- Cochrane Nigeria; Institute of Tropical Diseases Research and Prevention Calabar; University of Calabar Teaching Hospital; Calabar Nigeria
- Department of Pediatrics; College of Medical Sciences; University of Calabar; Calabar Nigeria
| |
Collapse
|
6
|
Anuforo PO, Oyedele L, Pacquiao DF. Comparative Study of Meanings, Beliefs, and Practices of Female Circumcision Among Three Nigerian Tribes in the United States and Nigeria. J Transcult Nurs 2016; 15:103-13. [PMID: 15070492 DOI: 10.1177/1043659603262486] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The study was conducted to gain insight into the meanings, beliefs, and practices of female circumcision among three Nigerian tribes in the United States and Nigeria. Participant-observations occurred in three sites in Nigeria (Ibadan, Lagos, and Owerri) and in Essex County, New Jersey (Newark, Irvington, and East Orange). A total of 50 informants included adult males and females from the three main Nigerian ethnic tribes: Igbo, Yoruba, and Hausa. Leininger’s culture care theory of diversity and universality was the study framework. Findings revealed existence of similarities and differences in the cultural meanings, beliefs, and practices among the tribes. Religion, education, and occupation were significant factors influencing informants’ attitudes toward continuation of the practice. Government-sponsored public education and influence by the media were found to increase informants’ awareness of complications of female circumcision. Changes in attitudes toward the practice and use of alternative practices were evident.
Collapse
|
7
|
Birge O, Ozbey EG, Arslan D, Erkan MM, Demir F, Akgor U. Vulvar Epidermoid Cyst and Type 2 Radical Genital Mutilation. Case Rep Obstet Gynecol 2015; 2015:520190. [PMID: 26682078 PMCID: PMC4670626 DOI: 10.1155/2015/520190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 10/16/2015] [Accepted: 11/04/2015] [Indexed: 11/18/2022] Open
Abstract
About 100 million women are estimated to be circumcised globally. Various rates of complications have been encountered, especially after circumcision, such as bleeding, infection, shock, menstrual irregularity, difficulty in urination or common urinary tract infections, inguinal pain, difficulty in sexual intercourse, and genital circumcision scar especially at the vulvar region, and cystic or solid character mass in short and long term. Furthermore, the maternal-fetal morbidity and mortality increase due to bleeding and fistula, which develop after prolonged labor, travail, and difficult labors. Our aim in this paper was to discuss a 42-year-old multiparous female case who had undergone type 2 radical genital mutilation (circumcision) when she was 7 years of age, along with the literature, which has been evaluated for the gradually growing mass at the left inguinal canal region in the last 10 years and diagnosed as epidermoid inclusion cyst developing secondary to postcircumcision surgical ground trauma, since there was no other case found in the literature search that had been circumcised at such an early age and developing after circumcision at such advanced age, and, therefore, this is suggested to be the first case on this subject.
Collapse
Affiliation(s)
- Ozer Birge
- Nyala Sudan Turkey Training and Research Hospital, Department of Gynecology and Obstetrics, Nyala, 7100 Darfur, Sudan
| | - Ertugrul Gazi Ozbey
- Nyala Sudan Turkey Training and Research Hospital, Department of Urology, Nyala, Darfur, Sudan
| | - Deniz Arslan
- Nyala Sudan Turkey Training and Research Hospital, Department of Urology, Nyala, Darfur, Sudan
| | - Mustafa Melih Erkan
- Celal Bayar University Hospital, Department of Gynecology and Obstetrics, Manisa, Turkey
| | - Feyza Demir
- Nyala Sudan Turkey Training and Research Hospital, Department of Pathology, Nyala, Darfur, Sudan
| | - Utku Akgor
- Nyala Sudan Turkey Training and Research Hospital, Department of Gynecology and Obstetrics, Nyala, 7100 Darfur, Sudan
| |
Collapse
|
8
|
Bhuria V, Malhotra V, Nanda S, Chauhan M, Goel B. Epidermoid Cyst of the Clitoris: An Unusual Case. J Gynecol Surg 2014. [DOI: 10.1089/gyn.2013.0081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Vandana Bhuria
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Sciences, Rohtak, India
| | - Vani Malhotra
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Sciences, Rohtak, India
| | - Smiti Nanda
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Sciences, Rohtak, India
| | - Meenakshi Chauhan
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Sciences, Rohtak, India
| | - Bhawana Goel
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Sciences, Rohtak, India
| |
Collapse
|
9
|
|
10
|
Excision of an enlarging vaginal epidermal inclusion cyst during pregnancy: a case report. J Low Genit Tract Dis 2012; 16:322-4. [PMID: 22382849 DOI: 10.1097/lgt.0b013e31823fcc43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The study aimed to report the case of a patient with an enlarging and symptomatic epidermal inclusion cyst during pregnancy that required surgical excision. MATERIALS AND METHODS This study was a case report of a 28-year-old woman (gravida 8, para 5, aborta 2) at a gestational age of 18 weeks 5 days who reported a tender vaginal mass that had grown larger for more than a week. RESULTS An enlarging symptomatic cystic mass was surgically excised. Histopathologic findings of the excised mass were consistent with an epidermal inclusion cyst with surrounding moderate chronic inflammation and cyst rupture. The patient's symptoms resolved completely by her postoperative visit. CONCLUSIONS Although most epithelial inclusion cysts are asymptomatic and can be managed expectantly, cysts that enlarge or become symptomatic should be excised surgically.
Collapse
|
11
|
Osifo OD. Post genital mutilation giant clitoral epidermoid inclusion cyst in Benin City, Nigeria. J Pediatr Adolesc Gynecol 2010; 23:336-40. [PMID: 20685139 DOI: 10.1016/j.jpag.2010.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Revised: 02/05/2010] [Accepted: 02/15/2010] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To report overall occurrence, and the mode of presentation and management of girls with post genital mutilation giant clitoral epidermoid inclusion cyst in an African subregion. METHODS This is a prospective experience with female patients who presented at two centers in Benin City, Nigeria, between January 2005 and December 2009 with clitoral epidermoid inclusion cyst following underground traditional female genital mutilation performed on neonates. RESULTS In total, 37 patients were seen with clitoral epidermoid inclusion cyst, 15 (40.5%) were post pubertal girls who could no longer cope with giant cyst that measured more than 3.5 × 6.5 cm in size at an average age of 17 (range 14-21) years. Ignorance, financial constraints, and the fear of possible prosecution by anti-female genital mutilation agencies were reasons for late presentation. Consequently, rapid increase in size of all cysts (100%), mass effect producing dragging discomfort in the vulva of 14 (93.3%) girls, social stigmatization of 12 (80%) girls by peers and spouses, sexual difficulty experienced by 10 (66.7%), and irritating bulge in the perineum of 10 (66.7%) girls, were the most common indications for surgical consultation. Outcomes of cystectomy that included total clitoridectomy performed on on an outpatient basis mainly with local anesthesia were encouraging with no incidence of recurrence recorded on 1-4 years postoperative follow-up. CONCLUSION Late presentation of girls with giant post genital mutilation clitoral epidermoid inclusion cysts was common. More campaigns against female genital mutilation and government policy aimed at encouraging patients with complications to seek early medical attention, and free treatment for those who present early are advocated.
Collapse
Affiliation(s)
- Osarumwense David Osifo
- Pediatric Surgery Unit, Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria.
| |
Collapse
|
12
|
Asante A, Omurtag K, Roberts C. Epidermal inclusion cyst of the clitoris 30 years after female genital mutilation. Fertil Steril 2010; 94:1097.e1-3. [PMID: 20236635 DOI: 10.1016/j.fertnstert.2010.02.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 01/28/2010] [Accepted: 02/01/2010] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To present a case report of a patient with epidermal inclusion cyst as a late complication of female circumcision, the management of the patient, and a review of the literature. DESIGN Case report and literature review. SETTING University hospital. PATIENT(S) A 37-year-old female from Guinea with a large clitoral mass of 6 months' duration. INTERVENTION(S) Complete history and physical exam of the patient and subsequent surgical resection of the cyst. MAIN OUTCOME MEASURE(S) Diagnosis, surgical management, and postoperative sexual function and emotional well-being. RESULT(S) Resolution of swelling and discomfort, satisfactory postoperative sexual function and emotional well-being. CONCLUSION(S) There should be awareness of one of the relatively common delayed complications of female genital circumcision and familiarity with its surgical management. Overall, surgical management appears to be effective, and there is no documented risk of recurrence.
Collapse
Affiliation(s)
- Albert Asante
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30303, USA.
| | | | | |
Collapse
|
13
|
Rizk DEE, Mohammed KH, Joshi SU, Al-Shabani AY, Bossmar TR. A large clitoral epidermoid inclusion cyst first presenting in adulthood following childhood circumcision. J OBSTET GYNAECOL 2009; 27:445-8. [PMID: 17654217 DOI: 10.1080/01443610701359910] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- D E E Rizk
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
| | | | | | | | | |
Collapse
|
14
|
Amusan OA, Asekun-Olarinmoye EO. Knowledge, beliefs, and attitudes to female genital mutilation (FGM) in Shao community of Kwara State, Nigeria. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2008; 27:337-49. [PMID: 18573755 DOI: 10.2190/iq.27.4.e] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To determine the level of knowledge, belief, and assess the attitude to female genital mutilation (FGM) and its complications in Shao community, Nigeria, a cross-sectional descriptive study with a health education intervention was used. A majority of respondents (99.5%) understood female circumcision to mean cutting off parts of the female genitals. There was a high level of knowledge regarding most of the complications of FGM as more than 50% of respondents knew at least four complications of FGM. Awareness of the global anti-FGM campaign was also high (78.8%). The most common reasons proffered for the practice of FGM were based on tradition or religion. Paternal grandfathers (50.0%) and fathers (21.0%) were cited as decision makers in the family most often responsible for requesting FGM. Post-intervention results showed that there was a statistically significant increase in the proportion of respondents who know more complications of FGM and who have no intention of circumcising future female children. Despite a high level of knowledge regarding the complications of FGM and a high level of awareness of the global campaign against it, there still exists a high prevalence of practice of FGM in this community. FGM remains a pressing human rights and public health issue. It is our recommendation that this health education intervention strategy be replicated nationwide especially using mass media.
Collapse
Affiliation(s)
- O A Amusan
- Ladoke Akintola University of Technology, Nigeria
| | | |
Collapse
|
15
|
Centeno-Wolf N, Chardot C, Le Coultre CP, La Scala GC. Infected urocolpos and generalized peritonitis secondary to labia minora adhesions. J Pediatr Surg 2008; 43:e35-9. [PMID: 18778986 DOI: 10.1016/j.jpedsurg.2008.04.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2007] [Revised: 03/29/2008] [Accepted: 04/26/2008] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Labia minora adhesions (LMA) are a common finding in young girls. Usually, this condition is asymptomatic and spontaneously disappears during adolescence. We report on a case revealed by infected urocolpos and peritonitis and whose treatment finally required surgical reduction labioplasty. CASE REPORT A 9-year-old girl presented with a 2-day history of abdominal pain and fever. Urinary continence had never been obtained, with diurnal leaks. Physical examination showed signs of peritoneal irritation and a subtotal vulvar obstruction due to LMA. At surgery, after LMA lysis, a large amount of cloudy urine-like fluid emptied under pressure from the vagina. Laparoscopy showed generalized peritonitis without any intraabdominal cause. The same Escherichia coli was identified in the infected urocolpos and the abdominal fluid. Postoperative course was uneventful. Because of recurrent LMA, the patient underwent several courses of local estrogen therapy. Labia minora hypertrophy with LMA developed 2 years after peritonitis, requiring surgical reduction labioplasty. We used a new technique with interposition of skin flaps. The girl is now well, without LMA or infection, 4 years after labioplasty. CONCLUSION Although rare, subtotal vulvar obstruction because of LMA may lead to infected hydrocolpos and peritonitis. Recurrent LMA may necessitate surgical labioplasty.
Collapse
Affiliation(s)
- Noemi Centeno-Wolf
- Pediatric Surgery Clinic, University of Geneva Childrens Hospital, Geneva, Switzerland
| | | | | | | |
Collapse
|