[罂粟摘要]全凭静脉或吸入麻醉对食管癌手术患者的影响：回顾性观察研究

全凭静脉或吸入麻醉对食管癌手术患者的影响：回顾性观察研究

贵州医科大学     麻醉与心脏电生理课题组

翻译 :  文春雷     编辑 :  严旭     审校 :  曹莹

背景：不同的麻醉药对免疫系统可能有相反的影响，从而影响肿瘤患者的预后。细胞介导的免疫是抵御肿瘤细胞侵袭的主要防御手段，因此增强免疫系统的抗肿瘤反应可以作为一种肿瘤辅助治疗。七氟醚具有促炎症作用，而异丙酚具有抗炎症和抗氧化作用。因此，我们比较了全凭静脉麻醉和吸入麻醉下食管癌患者的总生存期（OS）和无病生存期（DFS）。

方法：本研究收集了2014年1月1日至2016年12月31日接受食管切除术患者的电子病历。根据术中麻醉方式的不同，将患者分为全凭静脉麻醉（TIVA）组和吸入麻醉（INHA）组。采用稳定的逆概率处理加权（SIPTW）来最小化偏差。建立Kaplan-Meier生存曲线，评价不同麻醉方法与食管癌手术患者总生存期与无病生存期的相关性。

结果：共收集420例食管癌患者病历，其中363例符合研究条件的患者（TIVA，n=147，INHA，n=216）。SIPTW处理后，两组患者的总生存期和无病生存期均无显著差异。然而，辅助治疗对改善OS有统计学意义，且肿瘤分化程度与OS和DFS相关。

结论：综上所述，食管癌手术患者全凭静脉麻醉和吸入麻醉的总生存期和无病生存期均无显著差异。

原始文献来源 ：  

Yue Ma, Jie Ren, Zhuo Chen,et al.Outcomes of intravenous and inhalation anesthesia on patients undergoing esophageal cancer surgery: a retrospective observational study.[J].BMC Anesthesiology （2023）23:66.

英文原文

Outcomes of intravenous and inhalation 

anesthesia on patients undergoing esophageal cancer surgery: a retrospective observational 

study

Background: Diferent anesthetics may have opposite efects on the immune system, thus afecting the prognosis of tumor patients. Cell-mediated immunity forms the primary defense against the invasion of tumor cells, so manipulation of the immune system to produce an enhanced anti-tumor response could be utilized as an adjuvant oncological therapy. Sevofurane has proinfammatory efects, while propofol, has anti-infammatory and antioxidant efects. Therefore, we compared the overall survival (OS) and disease-free survival (DFS) of patients with esophageal cancer under total intravenous anesthesia and inhalation anesthesia.

Methods: This study collected the electronic medical records of patients undergoing esophagectomy from January 1, 2014 to December 31, 2016. According to the intraoperative anesthetics, the patients were divided into total intravenous anesthesia (TIVA) group or inhalational anesthesia (INHA) group. Stabilized inverse probability of treatment weighting (SIPTW) was used to minimize diferences. Kaplan–Meier survival curve was established to evaluate the correlation between diferent anesthesia methods in overall survival and disease-free survival of patients undergoing esophageal cancer surgery.

Results: A total of 420 patients with elective esophageal cancer were collected, including 363 patients eligible for study (TIVA, n=147, INHA, n=216). After SIPTW there were no signifcant diferences between two groups in overall survival and disease-free survival. However, the adjuvant therapy was statistically signifcant in improving OS, and the degree of diferentiation was correlated with OS and DFS.

Conclusions: In conclusion, there were no signifcant diference in overall survival and disease-free survival between total intravenous anesthesia and inhalational anesthesia in patients undergoing esophageal cancer surgery.

CORPORATE CULTURE

打赏