Effekt einer perioperativen Periduralanalgesie auf das Langzeitüberleben von Patienten nach Resektion eines kolorektalen Karzinoms

Holler, J.; Ahlbrandt, Janko; Gruß, Marco; Hecker, Andreas; Weigand, Markus; Padberg, Winfried; Röhrig, Rainer

doi:10.1007/s00104-014-2891-y

Cited by 1 publication

(1 citation statement)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Focusing on colorectal cancer, a retrospective single-centre study showed an improved 5-year survival from 54 to 62% (p = 0.001) in patients with an additional epidural catheter [48]. A systematic meta-analysis with five studies concerning colorectal cancer without metastasis confirmed a positive association: HR 0.81 (95% CI 0.68-0.96, p = 0.055) [49]. Another study described the same benefits for prostate cancer, but not for colorectal or other cancer types [50].…”

Section: Epidural Anaesthesiamentioning

confidence: 97%

Anaesthesia as an influence in tumour progression

Plücker

Wirsik

Ritter

et al. 2021

Langenbecks Arch Surg

View full text Add to dashboard Cite

Purpose Tumour growth and the formation of metastases are essential elements in the progression of cancer. The centre of treatment is the surgical resection of primary solid tumours. But even if the tumour can be removed without microscopic residual cells, local recurrences and distant metastases occur and determine the patient’s fate. During the operation, tumour cells are shed from the primary tumour and released into the circulation. These circulating tumour cells might play an important role in the formation of new tumour sites. Therefore, a functional innate and adaptive immune system is essential, especially in this perioperative period. Anaesthesia influences consciousness and pain perception and interacts directly with the immune system and tumour cells. Methods Review of the current literature concerning intra- and postoperative anaesthetic decisions and tumour progression. Results There are beneficial aspects for patient survival associated with total intravenous anaesthesia, the use of regional anaesthetics and the avoidance of allogeneic red blood cell transfusions. Alternatives such as irradiated intraoperative blood salvage and preoperative iron supplementation may be advantageous in cases where transfusions are limited or not wanted. The immunosuppressive properties of opioids are theoretical, but strong evidence to avoid them does not exist. The application of nonsteroidal anti-inflammatory drugs and postoperative nausea and vomiting prophylaxis do not impair the patient’s survival and may even have a positive effect on tumour regression. Conclusion Anaesthesia does play an important part in the perioperative period in order to improve the cancer-related outcome. Further research is necessary to make more concrete recommendations.

show abstract

Section: Epidural Anaesthesiamentioning

confidence: 97%