全静脉或吸入性挥发性麻醉与结直肠癌手术后的生存:瑞典国家登记研究

IF 7.5 1区 医学 Q1 ANESTHESIOLOGY
Anaesthesia Pub Date : 2024-12-16 DOI:10.1111/anae.16495
Anna Enlund, Maziar Nikberg, Anders Berglund, Erland Östberg, Mats Enlund
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引用次数: 0

摘要

回顾性研究表明,在癌症手术中使用吸入性挥发性麻醉剂可能会增加转移风险,降低生存率。由于不同的肿瘤生物学和不同的手术方法,这种关系可能在不同的癌症类型之间有所不同。本研究旨在调查2014年至2019年在瑞典接受全身麻醉切除手术的1-3期结直肠癌患者用于维持麻醉的麻醉剂类型(异丙酚或吸入性挥发性麻醉剂)与生存之间的关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Total intravenous or inhalational volatile anaesthesia and survival after colorectal cancer surgery: a Swedish national registry study

Total intravenous or inhalational volatile anaesthesia and survival after colorectal cancer surgery: a Swedish national registry study

Introduction

Retrospective studies suggest that inhalational volatile anaesthetic agents may contribute to an increased risk of metastasis and reduction in survival rates when used during cancer surgery. This relationship may vary between cancer types due to different tumour biology and differences in surgical procedures. This study aimed to investigate the relationship between the type of anaesthetic used for maintenance of anaesthesia (propofol or inhalational volatile anaesthetic agent) and survival in patients with stage 1–3 colorectal cancer who underwent resection surgery under general anaesthesia in Sweden between 2014 and 2019.

Methods

We identified patients from the Swedish Colorectal Cancer Registry. Their data, including cancer characteristics and adjuvant treatment, were then merged with information from the Swedish Peri-operative Registry. The primary outcome was overall survival, with disease-free survival as a secondary outcome.

Results

Of the 11,598 patients included, 8161 had colon cancer and 3437 had rectal cancer. General anaesthesia was maintained with propofol in 2346 (20%) patients, while 9252 (80%) received an inhalational volatile anaesthetic agent. In the unmatched cohort, patients who had general anaesthesia maintained with propofol for colon cancer surgery showed improved survival compared with those receiving an inhalational volatile anaesthetic agent (hazard ratio 0.83, 95%CI 0.72–0.95, p = 0.008). After 1:2 propensity score matching, we observed no significant difference in survival rates in this group (hazard ratio 0.89, 95%CI 0.76–1.04, p = 0.127). In the rectal cancer group, there was no difference in survival in either the unmatched cohort (hazard ratio 0.83, 95%CI 0.65–1.08, p = 0.166) or after propensity score matching (hazard ratio 0.95, 95%CI 0.71–1.25, p = 0.702). There was no significant difference in disease-free survival in either type of cancer.

Discussion

We found no association between the choice of agent for maintenance of anaesthesia and long-term survival outcomes in patients with colorectal cancer.

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来源期刊
Anaesthesia
Anaesthesia 医学-麻醉学
CiteScore
21.20
自引率
9.30%
发文量
300
审稿时长
6 months
期刊介绍: The official journal of the Association of Anaesthetists is Anaesthesia. It is a comprehensive international publication that covers a wide range of topics. The journal focuses on general and regional anaesthesia, as well as intensive care and pain therapy. It includes original articles that have undergone peer review, covering all aspects of these fields, including research on equipment.
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