The impact of anesthetic techniques on survival for patients with colorectal cancer: evidence based on six studies.

Hepato-gastroenterology Pub Date : 2015-03-01
Xizhi Sun, Changzhao Yang, Kezhong Li, Suchun Ding
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Abstract

Background/aims: Epidural-supplemented general anesthesia is perceived as a more beneficial method over general anesthesia since it reduces incidence of side effects, provides better postoperative pain relief and lowers the possibility to use immunosuppressive anesthetics. However, previous prospective and retrospective studies reported conflicting results in the effects of epidural anesthesia on post-operative outcomes of colorectal cancer surgery. Therefore, this study aims to pool available evidence to assess the association between epidural anesthesia and the post- operative outcomes in this group of patients.

Methodology: Relevant studies were searched in databases and a meta-analysis was performed to estimate the association between epidural anesthesia and overall survival and recurrence free survival.

Results: Compared with the anesthetic choice without epidural anesthesia, epidural-supplemented anesthesia is associated with significantly longer overall survival (HR: 0.72, 95% CI: 0.55-0.94, p = 0.01) but not with prolonged recurrence free survival (HR: 1.06, 95% CI: 0.96-1.16, p = 0.23). These results showed a highlevel of robustness in sensitive test.

Conclusion: Although epidural anesthesia might not lead to improved recurrence free survival, it had significant benefit in improving overall survival and reducing all-cause of death. It might be a useful anesthetic technique for colorectal cancer patients undergoing surgery. However, prospective studies are required to confirm whether this benefit is causative with epidural anesthesia.

麻醉技术对结直肠癌患者生存的影响:基于六项研究的证据。
背景/目的:硬膜外补充全身麻醉被认为是一种比全身麻醉更有益的方法,因为它减少了副作用的发生率,提供了更好的术后疼痛缓解,并降低了使用免疫抑制麻醉剂的可能性。然而,先前的前瞻性和回顾性研究报道了硬膜外麻醉对结直肠癌手术后预后的影响的相互矛盾的结果。因此,本研究旨在收集现有证据来评估硬膜外麻醉与这组患者术后预后之间的关系。方法:在数据库中检索相关研究,并进行荟萃分析,以估计硬膜外麻醉与总生存期和无复发生存期之间的关系。结果:与不选择硬膜外麻醉相比,硬膜外麻醉可显著延长总生存期(HR: 0.72, 95% CI: 0.55 ~ 0.94, p = 0.01),但与延长无复发生存期无关(HR: 1.06, 95% CI: 0.96 ~ 1.16, p = 0.23)。结果表明,敏感性试验具有较高的稳健性。结论:硬膜外麻醉虽然不能提高无复发生存率,但在提高总生存率和减少全因死亡方面有显著的益处。它可能是一种有用的大肠癌手术麻醉技术。然而,需要前瞻性研究来证实这种益处是否与硬膜外麻醉有关。
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
Hepato-gastroenterology
Hepato-gastroenterology 医学-外科
自引率
0.00%
发文量
1
审稿时长
1.9 months
期刊介绍: Hepato-Gastroenterology has been discontinued as of 2015. Extremely limited quantities of back issues in print available for sale.
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