【罂粟摘要】保乳手术中局部麻醉与全身麻醉对癌症复发和成本的影响

保乳手术中局部麻醉与全身麻醉对癌症复发和成本的影响

贵州医科大学     麻醉与心脏电生理课题组

翻译：严旭  编辑：陈锐 审核：曹莹

罂 粟 摘 要 

背景：所用的麻醉类型与癌症复发之间的关系仍有争议。本研究旨在比较局部麻醉与全身麻醉对保乳手术后无复发生存率和费用的影响。

方法：我们回顾了1999年至2014年期间在我们中心接受保乳手术后进行放射治疗的2778名患者的数据。我们分析了994名激素受体阳性和Her2阴性肿瘤患者的数据，这些患者在局麻或全麻下接受了保乳手术，没有进行腋窝淋巴结清扫。根据手术中使用的是局部麻醉还是全身麻醉，对患者进行分组。

结果：在参加这项研究的994名患者中，367人接受了局部麻醉，627名患者接受了全身麻醉。所有患者的中位随访时间为93个月。卡普兰-梅尔（Kaplan-Meier）生存曲线没有显示出两组的无复发生存率之间的显著差异，局部麻醉组的5年无复发生存率为96.3%（95%CI，94.3-98.3%），全身麻醉组为97.3%（95%CI，95.9-98.7%）。局部麻醉组的住院总费用明显低于全身麻醉组（P <.001）。在排除了165名在住院期间接受化疗的患者后，两组的费用差异仍很明显，不论是哪种住院方式。

结论：我们的分析表明，保乳手术中使用的麻醉类型与乳腺癌的长期预后之间没有关联。然而，局部麻醉下的保乳手术可能比全身麻醉下的保乳手术费用低。

原始文献来源：

Chongshan Gu , Lize Wang , Yingjian He , Tao Ouyang , Jinfeng Li , Tianfeng Wang , Tie Fan , Mi Li , Zhaoqing Fan

Effect of Local Versus General Anesthesia in Breast-Conserving Surgery on Cancer Recurrence and CostCancer Control. 2022 Jan-Dec;

PMID:35459407PMCID:PMC9036327DOI: 10.1177/10732748221083078

英文原文

Effect of Local Versus General Anesthesia in Breast-Conserving Surgery on Cancer Recurrence and Cost

Abstract

Background:The association between the type of anesthesia used and the recurrence of cancer remains controversial. This study aimed to compare the effects of local vs general anesthesia on recurrence-free survival and cost after breast-conserving surgery.

Materials and methods: We reviewed the data of 2778 patients who underwent breast-conserving surgery followed by radiation at our center between 1999 and 2014. We analyzed the data of 994 patients with hormone receptor-positive and Her2-negative tumors who underwent breast-conserving surgery without axillary lymph node dissection under local or general anesthesia. Patients were grouped according to whether local or general anesthesia was used for the surgery.

Results: Of the 994 patients enrolled in this study, 367 received local anesthesia and 627 patients received general anesthesia. The median follow-up duration for all patients was 93 months. The Kaplan-Meier survival curves did not reveal significant differences between the recurrence-free survival of the two groups, with 5-year recurrence-free survival rates of 96.3% (95% CI, 94.3-98.3%) in the local anesthesia group and 97.3% (95% CI, 95.9-98.7%) in the general anesthesia group. The total cost of hospitalization in the local anesthesia group was significantly lower than that in the general anesthesia group (P <.001). The difference in the cost between the two groups remained significant, irrespective of the type of hospitalization, after excluding 165 patients receiving chemotherapy during their hospitalization.

Conclusions: Our analysis indicated no association between the type of anesthesia used during breast-conserving surgery and the long-term prognosis of breast cancer. However, breast-conserving surgery under local anesthesia may be a less expensive option than that under general anesthesia.

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