ABSTRACT
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China. The Barcelona Clinic Liver Cancer (BCLC) staging system is regarded as the gold standard staging system for HCC, classifying HCC as early, intermediate, or advanced. For intermediate HCC, trans-catheter arterial chemoembolization (TACE) is recommended as the optimal strategy by the BCLC guideline. This review investigates whether liver resection is better than TACE for intermediate HCC. Based on published studies, we compare the survival benefits and complications of liver resection and TACE for intermediate HCC. We also compare the survival benefits of liver resection in early and intermediate HCC. We find that liver resection can achieve better or at least comparable survival outcomes compared with TACE for intermediate HCC; however, we do not observe a significant difference between liver resection and TACE in terms of safety and morbidity. We conclude that liver resection may improve the short- and long-term survival of carefully selected intermediate HCC patients, and the procedure may be safely performed in the management of intermediate HCC.
ABSTRACT
OBJECTIVE: To reveal if whether fennel fruit (Fructus Foeniculi) tea drinking enhances the recovery of intestinal function after gynecologic malignancies operation. METHODS: A total of 159 patients undergoing laparotomy for gynecological cancers were randomized into a tea group (n=78) and a control group (n=81). The patients in tea group drank a cup of fennel fruit tea while patients in control group drank the equal quantity of water twice per day from the first morning after operation until the first flatus. Every cup of tea consists of 5 gram of dried fennel fruit and 130 mL boiled water. The patents only drank the filtrate. Groups were compared in terms of time to first flatus and defecation, postoperative hospital stay, length of parenteral nutrition, ileus symptoms and other postoperative complications. RESULTS: Postoperative hospital [(5.6 +/- 1.2) d vs. (6.7 +/- 2.0) d, P<0.001], the mean time to flatus [(53.1 +/- 11.3) h vs. (64.2 +/- 13.6) h, P<0.001)], and the mean time to defecation [(4.3 +/- 1.0) d vs. (5.4 +/- 1.2) d, P < 0.001)] were significantly lower in tea group compared with those in control group. Ileus symptoms were observed more in patients in the control group compared to patients in tea group [relative risk = 2.6; 95% confidence interval, 1.5-4.5; P=0.001]. CONCLUSION: Fennel tea drinking after laparotomy for gynecological malignancis, an economical care, is safe, well to lerated and associated with rapider recovery of bowel motility, shorter hospital stay and fewer complications.
