Inhalation vs Total Intravenous Anesthesia in Cancer Surgery: Where is the «Pendulum» Now? (Meta-Analysis and Review)

Лихванцев, В. В.; Ядгаров, М. Я.; Piazza, Martina Di; Каданцева, К. К.

doi:10.15360/1813-9779-2020-6-91-104

Cited by 10 publications

(3 citation statements)

References 65 publications

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“…Likhvantsev et al believes that since the first laparoscopic cholecystectomy was reported in 1987, laparoscopic surgery has been widely used in the field of surgery for its advantages of small trauma, safety, simplicity, and quick postoperative recovery [ 4 ]. Bhattarai and Kamal noted that with the widening of the scope of adaptation and the increase of the difficulty of laparoscopic surgery, the pathophysiological changes caused by CO 2 pneumoperitoneum in the special working environment of laparoscopic surgery have been paid more and more attention by scholars.…”

Section: Literature Reviewmentioning

confidence: 99%

[Retracted] Application of Intravenous Anesthesia in Laparoscopic Hiatal Hernia Repair of Children

Zhu

Yang

et al. 2022

Contrast Media & Molecular Imaging

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In order to solve the stress problem in laparoscopic hiatal hernia repair of children, improve surgical safety, and reduce surgical risk, this study compared the perioperative changes of epinephrine, norepinephrine, IL-6, IL-10, and hemodynamics in children undergoing laparoscopic surgery under intravenous general anesthesia and general anesthesia combined with an epidural block. In this study, 40 children aged 1–3 years who planned to undergo laparoscopic ortopexy and those who planned to undergo laparoscopic high ligation of hernia sac, aged 23.84 1.6 months and weighed 14.9 1.1 kg, were randomly divided into general anesthesia combined with the epidural block group (group A) and a total intravenous anesthesia group (group B), with 20 subjects in each group. The results are as follows: There were no differences in age, gender, body weight, anesthesia time, pneumoperitoneum duration, and functional time between the two groups. Cytokines: Compared with T0, the levels of IL-6 in T2, T3, T4, and T5 groups were significantly increased ( P < 0.01). IL-10 levels: T2, T3, T4, and T5 groups were further increased, and the difference was statistically significant compared with T0 ( P < 0.01). There was no difference between groups ( P > 0.05). The recovery time in group B was shorter than that in group A ( P < 0.01), and the total amount of propofol and fentanyl in group B was less than that in group A ( P < 0.01). Through research on intravenous anesthesia treatment, it has been proved that total intravenous anesthesia can relieve perioperative pressure, reduce intravenous injection, and reduce the recovery time of children. However, its effect on cytokines is not obvious, so intravenous anesthesia is the most appropriate anesthesia mode in laparoscopic hiatal hernia repair surgery, which has practical significance.

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Section: Literature Reviewmentioning

confidence: 99%

[Retracted] Application of Intravenous Anesthesia in Laparoscopic Hiatal Hernia Repair of Children

Zhu

Yang

et al. 2022

Contrast Media & Molecular Imaging

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“…Таким образом, иммунитет, по-видимому, является основным звеном на пути реализации возможного негативного влияния анестезии на показатели послеоперационной выживаемости у онкологических больных. Данная стройная гипотеза, однако, пока недостаточно подтверждена результатами исследований, которые могли бы быть признаны убедительными в рамках доказательной медицины [9]. Возможно, один из существенных недостатков предыдущих…”

Section: Impact Of Anesthesia Methods On Immune Response In Patients ...unclassified

“…Учитывая высокий риск систематической ошибки в исходных обсервационных исследованиях, отсутствие статистической разницы по первичной конечной точке может трактоваться как сомнительный результат -мы не в состоянии ни подтвердить, ни опровергнуть влияние ингаляционной анестезии на иммунный статус пациенток, перенесших радикальную операцию по поводу рака молочной железы. Данная ситуация очень напоминает положение, сложившееся вокруг изучения влияния ингаляционной анестезии на иммунный статус и летальность у раковых больных, в целом: часть исследователей подобное влияние подтверждает [30,31], другая часть -не находит [9,32]. А результаты метаанализа не дают окончательного ответа [33,34].…”

Section: результатыunclassified

Impact of Anesthesia Method on Immune Response in Patients Undergoing Radical Surgery for Breast Cancer (a Meta-Analysis of Comparative Clinical Studies)

Лихванцев

Landoni

Субботин

et al. 2022

Obŝaâ reanimatologiâ

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Introduction and aim. Recent evidence suggests that inhalation anesthesia (IA) is associated with higher cancer mortality than total intravenous anesthesia (TIVA), possibly due to a modulation of the immune response.The aim of this study was to determine the impact of anesthesia techniques on selected parameters of patient immunity considering the evidence of relationship between the anesthesia methods and immune status and, consequently, the incidence of cancer recurrence.Methods. We performed a meta-analysis of clinical studies published in PubMed, Google Scholar, and Cochrane databases, aimed at assessing the impact of anesthesia on the postoperative immune status of patients undergoing breast cancer (BC) surgery. Five randomized and three observational studies were included (a total of 637 patients, of which 320 (50.2%) in the TIVA group). Data on leukocyte counts, matrix metalloproteinases (MMP) 9 and 3, interleukins (IL) 6 and 10 levels, and neutrophil-lymphocyte index (NLI) values were retrieved.Results. Patients after breast cancer surgery who underwent TIVA had significantly lower white blood cell counts (standardized mean difference (SMD)=–0.32; 95% CI: –0.58 to –0.06; I2=58%, P=0.020) and MMP-9 (SMD=–0.35; 95% CI: –0.67 to –0.03; P=0.030; I2=0%) in the postoperative period compared with patients receiving IA. No significant differences in the levels of MMP-3, IL-6, IL-10, and NLI values were found between the two groups.Conclusion. The patients who underwent breast cancer surgery under TIVA had lower blood leukocyte counts and levels of MMP-9, which is involved in the remodeling of extracellular matrix, compared with those operated on under IA, suggesting that the anesthesia method may have an impact on the immunity of breast cancer patients.

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Effect of Regional Anesthesia on Oncological Outcomes (Meta-Analysis)

Kadantseva,

Yadgarov,

Subbotin

et al. 2023

Obŝaâ reanimatologiâ

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Metastatic processes remain the main cause of deaths in oncology. Methods of anesthesia, in particular regional anesthesia, are considered as potential modulators of the immune response and metastatic spread. The ambiguity of the available data on the effect of regional and general anesthesia on metastatic spread is partly due to the fact that general anesthetic in combined anesthesia is quite often not taken into account, and this, in turn, masks the possible influence of regional anesthesia.The purpose of this meta-analysis was to make a comparative assessment of the effect of general anesthesia and general anesthesia in combination with regional anesthesia on the relapse-free and overall survival of cancer patients after surgery.Materials and methods. We analyzed 8 randomized controlled trials involving 1822 patients and comparing the groups of cancer patients who were operated either under general anesthesia (total intravenous (TIVA) or inhalation (IA)), or general anesthesia in combination with regional anesthesia (TIVA+RA or IA+RA, respectively). Trial using combinations of inhaled and intravenous anesthetics was excluded from the analysis for a more accurate assessment of the effect of regional anesthesia. The study complies with the recommendations of the Cochrane Community and PRISMA standards. The protocol was registered on the INPLASY platform. We used PubMed, Google Scholar and CENTRAL databases. We used a subgroup analysis and GRADE tool to assess the quality of evidence.Results. There were no statistically significant differences in relapse-free and overall survival when comparing different anesthesia methods. For a relapse-free survival, comparing TIVA vs TIVA+RA resulted in no significant difference : OR=1.20 [95% CI 0.92-1.55]; when IA vs IA+RA were compared, OR=1.10 [95% CI 0.94-1.29]. Similar results were obtained for overall survival.Conclusion. Based on the meta-analysis results, regional anesthesia had no effect on relapse-free and overall survival in oncosurgery patients.

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Inhalation vs Total Intravenous Anesthesia in Cancer Surgery: Where is the «Pendulum» Now? (Meta-Analysis and Review)

Cited by 10 publications

References 65 publications

[Retracted] Application of Intravenous Anesthesia in Laparoscopic Hiatal Hernia Repair of Children

[Retracted] Application of Intravenous Anesthesia in Laparoscopic Hiatal Hernia Repair of Children

Impact of Anesthesia Method on Immune Response in Patients Undergoing Radical Surgery for Breast Cancer (a Meta-Analysis of Comparative Clinical Studies)

Effect of Regional Anesthesia on Oncological Outcomes (Meta-Analysis)

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