Impact of anaesthetic technique on survival in colon cancer:a review of the literature  

麻醉技术对结肠癌患者术后生存期的影响:文献综述

作　　者：F.Jeroen Vogelaar Daan J.Lips Frank R.C.van Dorsten Valery E.Lemmens Koop Bosscha 

机构地区：[1]Department of Surgery,Jeroen Bosch Hospital,‘s-Hertogenbosch,the Netherlands [2]Department of Surgery,VieCuri Medical Centre,Venlo,the Netherlands [3]Department of Anaesthesiology,Jeroen Bosch Hospital,‘s-Hertogenbosch,the Netherlands [4]Department of Research,Netherlands Cancer Registry/Comprehensive Cancer Organisation The Netherlands,Eindhoven,the Netherlands [5]Department of Public Health,Erasmus MC University Medical Centre,Rotterdam,the Netherlands

出　　处：《Gastroenterology Report》2016年第1期30-34,I0002,共6页胃肠病学报道（英文）

摘　　要：An oncological surgical resection is the mainstay of treatment for potentially curable colon cancer.At the time of surgery,a large fraction of patients do harbour—although not visibly—minimal residual disease at the time of surgery.The immunosuppression that accompanies surgery may have an effect on disease recurrence and survival.Regional or neuraxial anaesthetic techniques like epidural anaesthesia may suppress immune function less than opioid analgesia,by reducing stress response and significantly reducing exposure to opioids.Consistent with this hypothesis,regional anaesthetic techniques have been associated with lower recurrence rates in breast cancer and prostate cancer.Results for colon cancer,however,are contradictory.In this review of the literature we describe all studies addressing the association of the use of epidural anaesthesia and survival in colon cancer surgery.对于潜在可根治的结肠癌,手术切除是核心治疗方式。尽管肉眼看不见,但大多数患者术中都会残留一些癌细胞。而手术本身所引起的免疫抑制也会影响到肿瘤复发和术后生存。相较于阿片类麻醉剂,区域阻滞麻醉或椎管内麻醉(如硬膜外麻醉)或可通过减少应激和降低阿片类麻醉剂的用量,减轻对免疫功能的抑制作用。研究显示,区域阻滞麻醉可降低乳腺癌和前列腺癌的复发率,从而印证了这一假设。然而对于结肠癌,相关研究结果却不尽一致。本文对所有探讨硬膜外麻醉与结肠癌手术患者生存相关性的研究进行了综述。

关 键 词：colon cancer epidural anaesthesia IMMUNOSUPPRESSION SURVIVAL 

分 类 号：R73[医药卫生—肿瘤]