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The goal of this paper is to review the existing literature regarding large HCC, with emphasis on identifying the issues and challenges involved in approaching these tumours surgically. A computerized search was made of the Medline database from January 1992 to December 2010. The MESH heading ��large�� or ��huge�� in combination with the keyword ��hepatocellular carcinoma�� was used. After excluding further studies that identified ��large�� HCC as less than http://www.selleck.cn/products/cobimetinib-gdc-0973-rg7420.html 10?cm and/or sequential publications with overlapping patient populations, the search produced a study population of 22 non-duplicated papers, reporting on a total of 5223 patients with HCC tumours >10?cm. Regarding resection for large HCC, the overall 5-year survival in these studies ranged from 25% to 45%, with few outliers on both sides, whereas in most studies, the 5-year disease-free survival ranged between 15% and 35%, with the only exception being studies with patients with single lesions and no cirrhosis showing disease-free survival of 41% and 56%, respectively. Risk factors identified included vascular invasion, cirrhosis, high level of alpha-fetoprotein and the presence of multiple lesions. Finally, liver transplantation, although an attractive concept, did not appear to offer a survival benefit in any of the studies. In conclusion, identifying the risk factors that affect the outcome in patients undergoing surgery for large HCC is critical. The reason http://www.selleckchem.com/products/poziotinib-hm781-36b.html is that surgical resection can have excellent outcomes in carefully selected patients. ""Background:? Laparoscopic rectal resection is now a technique that is emerging http://www.selleckchem.com/products/ganetespib-sta-9090.html from experience with laparoscopic colonic resection. We review and present our experience with restorative proctectomy for cancer and compare those performed with a hybrid technique with those performed totally laparoscopically. Methods:? A total of 177 patients have undergone laparoscopic restorative proctectomy. All of the patients were planned to have the abdominal portion of their surgery performed laparoscopically and to convert to open for the rectal dissection as required. They were then stratified into those that had their surgery performed completely laparoscopically (laparoscopic group �C LG), and to those who had their rectal dissection and or transection performed with an open incision (hybrid group �C HG). Results:? Short-term outcomes were compared between the LG (n?=?103) and the HG (n?=?74). The overall complication rate was higher in the HG (12% versus 35% P?