Efficacy of 5-HT3 receptor antagonists (ondansetron) vs dopamine receptor antagonists (droperidol) for preventing postoperative nausea, vomiting and headache: a meta-analysis

Objective To investigate the effects of 5-hydroxytryptamine 3 receptor antagonists (ondansetron [OND]) versus dopamine receptor antagonists (droperidol [DRO]) in the prevention of postoperative nausea, vomiting (PONV) and headache by pooling data from open published studies. Methods Performed systematic electronic searches of PubMed, Embase, Google scholar and CNKI, to identify open-published prospective randomized controlled trials (RCTs) relevant to the comparison of OND versus DRO for preventing PONV and headache to be included in the present study. The pooled PONV, headache, dizziness and drowsiness were calculated based on the original data of each included study. The pooled data was presented with risk ratio (RR) and 95% confidence interval (95%CI). Results Thirteen prospective randomized clinical trials were included in this meta-analysis. The pooled PONV, post-operative nausea (PON) and positive operative vomiting (POV) were 0.67 (95%CI:0.48-0.93, p0.05) and 0.56 (95%CI:0.39-0.82,p0.05), 0.63 (95%CI:0.21-1.87, p>0.05) and 0.48(0.28-0.81,p<0.05) respectively by fixed effect model for OND vs. DRO. Conclusion The post-operative nausea, vomiting and dizziness risks were significant decreased for patients receiving OND compared to patients receiving DRO

Long-term outcomes of percutaneous cryoablation for patients with hepatocellular carcinoma within Milan criteria.

BackgroundAccumulating evidences have suggested that percutaneous cryoablation could be a valuable alternative ablation therapy for HCC but there has been no large cohort-based analysis on its long-term outcomes.MethodsA series of 866 patients with Child-Pugh class A-B cirrhosis and HCC within Milan criteria who underwent percutaneous cryoablation was long-term followed. The safety, efficacy, 5-year survival, and prognostic factors of percutaneous cryoablation in the treatment of HCC were analyzed.ResultsA total of 1197 HCC lesions were ablated with 1401 cryoablation sessions. Complete response (CR) was achieved in 1163 (97.2%) lesions and 832 (96.1%) patients with 34 (2.8%) major complications, but no treatment-related mortality. After a median of 30.9 months follow-up, 502 (60.3%) patients who achieved CR developed different types of recurrence. The cumulative local tumor recurrence rate was 24.2% at 5-years. Multiple tumor lesions, tumor size &gt; 3 cm, and repeated ablation of same lesion were independent risk factors associated with local recurrence. The 5-year overall survival (OS) rates were 59.5%. Age &lt; 36 years, HCC family history, baseline hepatitis B virus DNA &gt;106 copies/ml, and three HCC lesions were independently and significantly negative predictors to the post-cryoablation OS.ConclusionsPercutaneous cryoablation is an effective therapy for patients with HCC within Milan criteria, with comparable efficacy, safety and long-term survival to the reported outcomes of radiofrequency ablation

Overall survival curves of patients treated by percutaneous cryoablation.

<p>The OS curve of 832 patients who received percutaneous cryoablation as the first-line treatment.</p

Baseline Characteristics of 866 HCC Patients Underwent Cryoablation and Were Included in the Present Study.

<p>Baseline Characteristics of 866 HCC Patients Underwent Cryoablation and Were Included in the Present Study.</p

Flow chart of the present study.

<p>HCC, hepatocellular carcinoma; TACE, transarterial chemoembolization; Cryo, cryoablation; SOR, sorafenib; OLT, orthotropic liver transplantation; RFA, radiofrequency ablation; SR, surgical resection; BSC, best supportive care.</p

Summary of the Complications from 1197 Cryoablation-treated HCC Lesions.

<p>Summary of the Complications from 1197 Cryoablation-treated HCC Lesions.</p