AIMTo assess the viability of orthotopic and heterotopic patient-derived pancreatic cancer xenografts implanted into nude mice.METHODSThis study presents a prospective experimental analytical follow-up of the development of tumours in mice upon implantation of human pancreatic adenocarcinoma samples. Specimens were obtained surgically from patients with a pathological diagnosis of pancreatic adenocarcinoma. Tumour samples from pancreatic cancer patients were transplanted into nude mice in three different locations (intraperitoneal, subcutaneous and pancreatic). Histological analysis (haematoxylin-eosin and Masson’s trichrome staining) and immunohistochemical assessment of apoptosis (TUNEL), proliferation (Ki-67), angiogenesis (CD31) and fibrogenesis (α-SMA) were performed. When a tumour xenograft reached the target size, it was re-implanted in a new nude mouse. Three sequential tumour xenograft generations were generated (F1, F2 and F3).RESULTSThe overall tumour engraftment rate was 61.1%. The subcutaneous model was most effective in terms of tissue growth (69.9%), followed by intraperitoneal (57.6%) and pancreatic (55%) models. Tumour development was faster in the subcutaneous model (17.7 ± 2.6 wk) compared with the pancreatic (23.1 ± 2.3 wk) and intraperitoneal (25.0 ± 2.7 wk) models (P = 0.064). There was a progressive increase in the tumour engraftment rate over successive generations for all three models (F1 28.1% vs F2 71.4% vs F3 80.9%, P < 0.001). There were no significant differences in tumour xenograft differentiation and cell proliferation between human samples and the three experimental models among the sequential generations of tumour xenografts. However, a progressive decrease in fibrosis, fibrogenesis, tumour vascularisation and apoptosis was observed in the three experimental models compared with the human samples. All three pancreatic patient-derived xenograft models presented similar histological and immunohistochemical characteristics.CONCLUSIONIn our experience, the faster development and greatest number of viable xenografts could make the subcutaneous model the best option for experimentation in pancreatic cancer.

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Single-port Roux-en-Y gastric bypass surgery seems to be a safe, viable, and reproducible technique, but randomized studies involving larger patient series and longer follow-up periods are needed to compare the SP access and the multiple-port laparoscopic approach.

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Background Many clinical guidelines recommend the preoperative administration of Lugol's solution (LS) for patients undergoing thyroidectomy for Graves’ disease (GD), mainly based on low-quality evidence. Our aim was to assess its influence on intra and postoperative outcomes in patients undergoing total thyroidectomy (TT) for GD. Methods We performed a nationwide multicentre randomised controlled trial including euthyroid patients scheduled for TT due to GD. Patients were randomised for either receiving or not preoperative LS. Surgeons were blinded for treatment assignment. The primary outcome was the overall rate of postoperative complications. Secondary outcomes were intraoperative events and permanent morbidity. Results 136 patients were included (68 in each arm), without preoperative differences among groups. The rate of patients who developed any complication was 51.5% in LS arm vs. 50% in controls (p=1). Postoperative hypocalcaemia appeared in 45.6% vs. 38.2% (p=0.487). The rate of postoperative vocal cord palsy was 6.1% vs. 3.3% (p=0.682). Median Thyroidectomy Difficulty Scale score was slightly higher in the LS group (10 vs. 9; p=0.031). No differences among groups were observed regarding surgical time, intraoperative bleeding, gland weight, or the rate of loss of signal in neuromonitoring. Long-term results have not yet been evaluated. Conclusion Preoperative iodine preparation can be safely obviated facing TT for GD, regarding the intraoperative difficulty and postoperative complications. If long-term results sustain these results, current advice for presurgical preparation in GD could be challenged.

Introduction: Post-transplant lymphoproliferative syndrome (PTLD) is a rare and potentially life-threatening complication after liver transplantation. The aim of this study was to analyze the clinicopathologic features related to PTLD in a single institution after liver transplantation.Methods: Observational study where we have retrospectively analyzed 851 cases who underwent liver transplantation. Ten cases have developed PTLD. Their clinical-pathological characteristics and the treatment received have been analyzed.Results: PTLD incidence was 1.2% (10/851). The mean time from liver transplantation to PTLD diagnosis was 36 months (range 1.2 to 144 months). PTLD localization was extranodal in all cases, the most frequent location being intestinal. Seven cases showed a monomorphic lymphoma which in all cases was differentiated B cell lymphomas. Fifty per cent of the series were seropositive for Epstein-Barr virus. Five patients were alive at the time of the review. Among these patients, we observed three cases of complete remission and two cases of disease stabilization. The death rate was higher in the first year after diagnosis of PTLD.Conclusion: PTLD is a rare complication after liver transplantation, but it may pose a threat to the life of a liver transplant recipient. It is essential to identify patients at risk, to establish an early diagnosis and treatment that can change the outcome of the disease.