LE is a safe and feasible technique for the benign or low malignant-potential pancreatic neoplasms. Compared to OE, LE had shorter operating time, lower estimated blood loss, and faster recovery. LE could preserve the pancreatic function as the OE.

Laparoscopic resection for gastric GISTs is a safe and feasible procedure with less blood loss, less overall complications and quicker recovery. The long-term survival situation of patients mainly depends on the tumor itself risk, and laparoscopic surgery will not increase the risks of tumor relapse and metastasis.

endowed exosomes with different biological functions such as immune response and intercellular communication. [2-4] Molecular profiling of tumor-associated exosomes especially surface proteins and miRNAs has been used in cancer diagnosis and monitoring of treatment response. [5,6] For example, exosomal surface proteins such as CD24, epithelial cell adhesion molecule (EpCAM), epidermal growth factor receptor (EGFR), and ephrin type-A receptor 2 (EphA2) can be used for cancer diagnosis, exosome enrichment, and as normalization indicators for exosome concentrations. [7-10] Also, owing to the high stability of miRNAs in exosomes, exosomal miRNAs have been used as new biomarkers of various cancers, such as lung, [11] pancreatic, [12] breast, and prostate cancers. [13,14] Thus, surface proteins and miRNAs of exosomes could provide much information on disease progression. Currently, significant progress has been made toward exosome separation and detection with improved sensitivity, multiplicity, and speed. Among these, integrated microfluidic chips are one of the most practical solutions, owing to their ability to simultaneously separate and detect exosomal biomarkers. To date, two kinds of microfluidic platforms, immunoaffinitybased and size-based exosome isolation, have been reported. Immunoaffinity-based exosome isolation was performed by manipulating affinity particles/magnetic bead, [15-17] or modifying microchannel surface with antibodies (Abs). [18,19] Microfluidic Exosomes are recognized as promising biomarkers for early cancer diagnosis and prognosis owing to a large amount of biological information they carried. But the key is that single type of exosomal biomarker analysis is not sufficient enough for accurate cancer diagnosis and stage monitoring due to the insufficient information and high false positive signal. To address the challenge, here simultaneous in situ detection of different types of exosomal biomarkers (surface proteins: CD81, ephrin type-A receptor 2, and carbohydrate antigen 19-9; miRNAs: miR-451a, miR-21, and miR-10b) is conducted with a 3D microfluidic chip, which works in conjunction with quantum dot (QD) labeling and vesicle fusion technology. After exosomes are efficiently captured by the microfluidic chip, the quantification of multiple exosomal proteins is achieved by using three kinds of QDs with the same excitation and different emission wavelengths, and virus-mimicking fusogenic vesicles encapsulating three exquisitely engineered molecular beacons are introduced for ultrasensitive detection of multiple exosomal miRNAs without requiring RNA extraction. Through comprehensive profiling different types of exosomal biomarkers, the false positive rate is substantially avoided and the accuracy of cancer diagnosis and stage monitoring is improved to ≈100%, which are critical to cancer effective treatment and favorable prognosis.

BackgroundA growing body of evidence supports the use of laparoscopic pancreaticoduodenectomy (LPD) as an efficient and feasible surgical technique. However, few studies have investigated its applicability in pancreatic ductal adenocarcinoma (PDAC), and the long-term efficacy of LPD on PDAC remains unclear. This study aimed to compare the short- and long-term outcomes between LPD and open pancreaticoduodenectomy (OPD) for PDAC.MethodsThe data of patients who had OPD or LPD for PDAC between January 2013 and September 2017 were retrieved. Their postoperative outcomes and survival were compared after propensity score matching.ResultsA total of 309 patients were included. After a 2:1 matching, 93 cases in the OPD group and 55 in the LPD group were identified. Delayed gastric emptying (DGE), particularly grade B/C DGE, occurred less frequently in the LPD group than in the OPD group (1.8% vs. 36.6%, P < 0.001; 1.8% vs. 22.6%, P = 0.001). The overall complication rates were significantly lower in the LPD group than in the OPD group (49.1% vs. 71.0%, P = 0.008), whereas the rates of major complications were similar (10.9% vs. 14.0%, P = 0.590). In addition, the median overall survival was comparable between the two groups (20.0 vs. 18.7 months, P = 0.293).ConclusionLPD was found to be technically feasible with efficacy similar to OPD for patients with PDAC.