Anesthesia-related postoperative oncological surgical outcomes: a comparison of total intravenous anesthesia and volatile anesthesia. A meta-analysis

IF 1.6 4区医学 Q2 SURGERY

Videosurgery and Other Miniinvasive Techniques Pub Date : 2023-12-27 DOI:10.5114/wiitm.2023.133916

Qiaoqin Yan, Haofeng Liang, Hengming Yin, Xianhua Ye

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Abstract

Introduction
In patients undergoing cancer surgery, it is ambiguous whether propofol-based total intravenous anesthesia (TIVA) elicits a significantly higher overall survival rate than volatile anesthetics (VA). Consequently, evaluating the impact of TIVA and VA on long-term oncological outcomes is crucial.

Aim
This study compared TIVA versus VA for cancer surgery patients and investigated the potential correlation between anesthetics and their long-term surgical outcomes.

Material and methods
A comprehensive search of Medline, EMBASE, Scopus, and Cochrane Library identified English-language peer-reviewed journal papers. The statistical measurements of hazard ratio (HR) and 95% CI were calculated. We assessed heterogeneity using Cochrane Q and I2 statistics and the appropriate p-value. The analysis used RevMan 5.3.

Results
The meta-analysis included 10 studies with 14036 cancer patients, 6264 of whom received TIVA and 7777 VA. In this study, we examined the long-term oncological outcomes of cancer surgery patients with TIVA and VA. Our data show that the TIVA group had a considerably higher overall survival rate (HR = 0.49, 95% CI: 0.30–0.80) and recurrence-free survival rate (HR = 0.56, 95% CI: 0.32–0.97). Each outcome was statistically significant (p < 0.05).

Conclusions
The present study concludes that TIVA is a more effective anesthetic agent than VA in obtaining better long-term oncological outcomes in cancer patients after surgery as it provides a higher overall survival rate, a higher recurrence-free survival rate and fewer post-operative pathological findings in patients who have undergone surgery for cancer as compared to VA.

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与麻醉相关的肿瘤手术术后结果：全静脉麻醉与挥发性麻醉的比较。荟萃分析

导言在接受癌症手术的患者中，以丙泊酚为基础的全静脉麻醉（TIVA）是否比挥发性麻醉药（VA）能显著提高总生存率尚不明确。因此，评估 TIVA 和 VA 对长期肿瘤预后的影响至关重要。本研究比较了癌症手术患者使用 TIVA 和 VA 的情况，并调查了麻醉药与其长期手术预后之间的潜在相关性。计算了危险比（HR）和 95% CI 的统计测量值。我们使用 Cochrane Q 和 I2 统计量以及适当的 p 值评估了异质性。分析使用 RevMan 5.3。结果荟萃分析纳入了 10 项研究，共研究了 14036 名癌症患者，其中 6264 人接受了 TIVA 治疗，7777 人接受了 VA 治疗。在这项研究中，我们考察了接受 TIVA 和 VA 的癌症手术患者的长期肿瘤治疗效果。我们的数据显示，TIVA 组的总生存率（HR = 0.49，95% CI：0.30-0.80）和无复发生存率（HR = 0.56，95% CI：0.32-0.97）明显更高。本研究得出结论，与 VA 相比，TIVA 是一种更有效的麻醉剂，能为癌症患者术后获得更好的长期肿瘤治疗效果，因为与 VA 相比，TIVA 能为癌症患者提供更高的总生存率、无复发生存率以及更少的术后病理结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Videosurgery and Other Miniinvasive Techniques 医学-外科

CiteScore

2.80

自引率

23.50%

发文量

审稿时长

12 weeks

期刊介绍： Videosurgery and other miniinvasive techniques serves as a forum for exchange of multidisciplinary experiences in fields such as: surgery, gynaecology, urology, gastroenterology, neurosurgery, ENT surgery, cardiac surgery, anaesthesiology and radiology, as well as other branches of medicine dealing with miniinvasive techniques.