ABSTRACT
PURPOSE: Laparoscopic duodenum-preserving total pancreatic head resection (LDPPHRt) is used for treating benign or low-grade malignant tumors of the pancreatic head. However, preservation of the duodenum and biliary tract integrity remains challenging. We present a new approach for LDPPHRt and evaluate its feasibility and safety. METHODS: From April 2020 to December 2020, 30 patients successfully underwent LDPPHRt using the intracapsular approach in our center. Their medical records were reviewed for relevant clinical characteristics, pathologic findings, postoperative complications, and survival. RESULTS: The median diameter of the lesions was 3.6 cm (range, 2.0-5.5 cm). The median operative time was 234.7 min (range, 195-310 min). The median blood loss was 66.7 ml (range, 20-250 ml). The morbidity rate was 26.7%, including POPF, hemorrhage, lymphatic leakage, wound infection, pulmonary infection, and delayed gastric emptying. Five patients developed pancreatic fistula type A, and two patients had type B, classified according to the International Study Group on Pancreatic Fistula. No biliary tract injury or duodenal leakage was observed. The median postoperative hospital stay was 11.5 days (range, 6-25), and the operative mortality rate was 0%. CONCLUSION: The intracapsular approach is a feasible and safe surgical procedure in LDPPHRt for patients with benign or low-grade malignant tumors, especially those without severe pancreatic head fibrosis or peripancreatic adhesions.
Subject(s)
Laparoscopy , Pancreatic Neoplasms , Humans , Pancreatic Fistula/surgery , Pancreatic Neoplasms/surgery , Pancreatic Neoplasms/pathology , Pancreas/surgery , Pancreatectomy/methods , Duodenum/surgery , Laparoscopy/methods , Postoperative Complications/epidemiology , Postoperative Complications/surgeryABSTRACT
Stomatinlike protein 2 (SLP2) is associated with poor prognosis in several types of cancer, including pancreatic cancer (PC); however, the molecular mechanism of its involvement remains elusive. The present study aimed to elucidate the role of this protein in the development of PC. Human PC cell lines AsPC1 and PANC1 were transfected by a vector expressing SLP2 shRNA. Analyses of cell proliferation, migration, invasion, chemosensitivity, and glucose uptake were conducted, while a mouse xenograft model was used to evaluate the functional role of SLP2 in PC. Immunohistochemical analysis was retrospectively performed on human tissue samples to compare expression between the primary site (n=279) and the liver metastatic site (n=22). Furthermore, microarray analysis was conducted to identify the genes correlated with SLP2. In vitro analysis demonstrated that cells in which SLP2 was suppressed exhibited reduced cell motility and glucose uptake, while in vivo analysis revealed a marked decrease in the number of liver metastases. Immunohistochemistry revealed that SLP2 was increased in liver metastatic sites. Microarray analysis indicated that this protein regulated the expression of glutaminefructose6phosphate transaminase 2 (GFPT2), a ratelimiting enzyme of the hexosamine biosynthesis pathway. SLP2 contributed to the malignant character of PC by inducing liver metastasis. Cell motility and glucose uptake may be induced via the hexosamine biosynthesis pathway through the expression of GFPT2. The present study revealed a new mechanism of liver metastasis and indicated that SLP2 and its downstream pathway could provide novel therapeutic targets for PC.
Subject(s)
Blood Proteins/metabolism , Carcinoma, Pancreatic Ductal/genetics , Glutamine-Fructose-6-Phosphate Transaminase (Isomerizing)/genetics , Hexosamines/biosynthesis , Liver Neoplasms/genetics , Membrane Proteins/metabolism , Pancreatic Neoplasms/genetics , Adult , Aged , Aged, 80 and over , Animals , Apoptosis/genetics , Biosynthetic Pathways/genetics , Blood Proteins/genetics , Carcinoma, Pancreatic Ductal/secondary , Cell Line, Tumor , Cell Movement/genetics , Cell Proliferation/genetics , Disease Progression , Female , Gene Expression Regulation, Neoplastic , Gene Silencing , Glucose/metabolism , Glutamine-Fructose-6-Phosphate Transaminase (Isomerizing)/metabolism , Humans , Liver Neoplasms/secondary , Male , Membrane Proteins/genetics , Mice , Middle Aged , Neoplasm Invasiveness/genetics , Pancreatic Neoplasms/pathology , Retrospective Studies , Xenograft Model Antitumor AssaysABSTRACT
Objective To investigate the attentional network in patients with temporal lobe epilepsy(TLE) and the disease-related factors. Methods Fity-four patients with TLE and 40 controls were enrolled in our hospital from January 2007 to December 2008.The computerized ANT software was used for evaluating the attentional network efficiency and the clinical date of the patients with TLE were recorded. Logistic regression was used to identify the risk factors of attentional network efficiency. Results The mean reaction time(TLE:688.2±138.1 ms;Control:625.1±100.1 ms, t=2.06, P <0.05)and executive control network efficiency (TLE:155.7±57.0 ms;Control:108.0±33.8 ms, t=4.62, P <0.01) of the TLE group were lower than the healthy control group. The efficiency of alerting network and orienting network between the two groups were no significant difference. Logistic regression analysis showed that the positive epileptiform activity was an independent risk factor of the attentional impairment(95% CI : 1.03～42.33, OR =6.603, P =0.043). Conclusions The ANT demonstrate that patients with TLE may accompany with attentional executive control network efficiency impairment. Epileptiform discharge may cause attentional executive network efficiency impairment.
