Minimally invasive pancreatic surgery: An upward spiral

Zhu, Ruizhe; Cao, Zhe; Qiu, Jiangdong; Zhang, Taiping

doi:10.1016/j.lers.2020.04.003

Cited by 6 publications

(3 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, the use of robotics with minimally invasive interventions has been studied and its results have been compared with laparoscopy, with very different outcomes according to the different studies. (84,85) In some of them, a greater number of complications (fistula, hemorrhage and perforation) were observed with the robotic intervention; however, it must be remembered that there are few specialists trained in this type of technique and that this type of approach requires a high level of training that may not be available at a number of centers (86,87). Likewise, it cannot be overlooked that the greatest limitation when considering surgical intervention is vascular invasion.…”

Section: Surgery Is Becoming Less and Less Invasivementioning

confidence: 99%

Towards an updated view on the clinical management of pancreatic adenocarcinoma: Current and future perspectives (Review)

et al. 2021

View full text Add to dashboard Cite

Pancreatic cancer has a dire prognosis and will represent the second leading cause of cancer death in the next 10 years. The multifactorial approach represents one of the main issues in controlling the extension of this neoplasm. In recent years, the characteristics of the tumor microenvironment, metastasis mechanisms and the relationship between immune system and neoplastic cells have been described, which has made it possible to understand the pathophysiology of pancreatic adenocarcinoma. Currently, there is a failure to provide an effective preventive method or early detection, so patients present with an advanced stage at the time of diagnosis. Despite numerous efforts, little progress has been made in clinical outcome and in improving survival in long term. Therefore, in the recent years, diverse diagnostic tests, treatments and possible approaches have been developed in the fields of radiotherapy, chemotherapy and surgery to find a combination of them that improves life expectancy in patients diagnosed with pancreatic cancer. At the moment, numerous clinical trials are being conducted to evaluate preventive diagnostic procedures such as serological markers or perfecting available imaging tests. On the other hand, implementation of immunotherapy is being studied in a neoplasm that has lagged in the application of this procedure since present possible treatments do not substantially improve quality of life. Therefore, the purpose of our study is to summarize the main progresses that have been made in the diagnosis, treatment and screening of this disease, explaining the limitations that have been observed and analyzing future prospects in the management of this illness.

show abstract

Section: Surgery Is Becoming Less and Less Invasivementioning

confidence: 99%

Towards an updated view on the clinical management of pancreatic adenocarcinoma: Current and future perspectives (Review)

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The concept of learning curve became particularly popular with the advent of minimally invasive surgery, when surgeons needed to completely rethink their abilities and adapt them to new techniques and technologies. It has also been postulated that the learning curve appears to be longer in MIS relative to open surgery, and that the curve becomes steeper and steeper with the increasing complexity of surgical procedures [5] . For complex major abdominal surgeries, a great number of procedures is required to master the technique, and there may be dangerously high morbidity and mortality rates at the beginning of the learning curve.…”

Section: Mis In the Pancreatic Surgery Field: A Steep Pathmentioning

confidence: 99%

What role does hand-assistance have in minimally invasive pancreatic surgery?

Donisi¹,

Zerbi²

2021

MIS

View full text Add to dashboard Cite

Surgery poses an important stress on the patient from both physical and psychological points of view per se. It has become clearer with time that, regardless of the type of surgical operation, a smaller surgical incision could reduce the operation-induced stress. With advancements in technology, great efforts have been made in trying to reduce this burden on the patient, leading to the development of minimally invasive surgery (MIS) [1,2] . MIS has gained increasing support since its introduction and has undergone continuous improvements and evolutions to the point of becoming, nowadays, the standard of care for many surgical procedures such as cholecystectomy, adrenalectomy, splenectomy, and fundoplication. MIS encompasses several different approaches which have in common the aim of decreasing the impact of the surgical operation on the patient. The first approach to be developed and widely accepted in clinical practice was laparoscopy. Among the well-established advantages of laparoscopic surgery, we have decreased pain, shorter length of stay, faster postoperative recovery, and a better visualization of secluded anatomical spaces which would otherwise require a large incision to be correctly exposed [3] . All of this comes at the price of decreased dexterity, diminished tactile feedback, and inherent limitations posed by restricted degrees of freedom of laparoscopic instrumentation, which may result in a longer operative time compared to the open approach for complex surgical procedures [4] . In recent years, an alternative to the laparoscopic technique has been proposed with the introduction of robotic platforms in surgery. Potential advantages of robotic surgery are filtration of tremors, better dexterity, higher degrees of freedom with the EndoWrist system, and better Not applicable.

show abstract

“…With worldwide increases in smoking, alcohol abuse, diabetes, chronic pancreatitis, and obesity, the new prevalence of PDAC is increasing yearly, and it is the 4 th leading cause of cancer-related death worldwide ( 2 , 3 ). Surgical resection is currently the main treatment for PDAC, but due to the nonspecific symptoms of PDAC, most patients have already progressed to advanced stage when diagnosed ( 4 , 5 ). Even after surgery, the prognosis is poor, and the 5-year survival rate is about 11% ( 1 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Platelet-Vesicles-Encapsulated RSL-3 Enable Anti-Angiogenesis and Induce Ferroptosis to Inhibit Pancreatic Cancer Progress

et al. 2022

View full text Add to dashboard Cite

Pancreatic ductal adenocarcinoma (PDAC) is one of the most malignant cancers. It is characterized by stromal richness, lack of blood supply and special metabolic reprogramming in the tumor microenvironment, which is difficult to treat and easy to metastase. Great efforts have been made to develop new drugs which can pass through the stroma and are more effective than traditional chemotherapeutics, such as ferroptosis inducers–Erastin and RSL-3. As current anti-angiogenic therapy drugs alone are suboptimal for PDAC, novel vascular disruption agents in combination with ferroptosis inducers might provide a possible solution. Here, we designed human platelet vesicles (PVs) to camouflage RSL-3 to enhance drug uptake rate by tumor cells and circulation time in vivo, deteriorating the tumor vessels and resulting in tumor embolism to cut the nutrient supply as well as causing cell death due to excessive lipid peroxidation. The RSL-3@PVs can also cause the classic ferroptosis-related change of mitochondrial morphology, with changes in cellular redox levels. Besides that, RSL-3@PVs has been proved to have great biological safety profile in vitro and in vivo. This study demonstrates the promising potential of integrating PVs and RSL-3 as a combination therapy for improving the outcome of PDAC.

show abstract

Minimally invasive pancreatic surgery: An upward spiral

Cited by 6 publications

References 44 publications

Towards an updated view on the clinical management of pancreatic adenocarcinoma: Current and future perspectives (Review)

Towards an updated view on the clinical management of pancreatic adenocarcinoma: Current and future perspectives (Review)

What role does hand-assistance have in minimally invasive pancreatic surgery?

Platelet-Vesicles-Encapsulated RSL-3 Enable Anti-Angiogenesis and Induce Ferroptosis to Inhibit Pancreatic Cancer Progress

Contact Info

Product

Resources

About