Beloeil H, Nouette-Gaulain K
Inserm UMR 991, service anesthésie et réanimation, centre hospitalier universitaire de Rennes, 35033 Rennes, France.
Ann Fr Anesth Reanim. 2012 Jun;31(6):528-36. doi: 10.1016/j.annfar.2012.01.037. Epub 2012 Mar 31.
Surgical treatment of cancer is usually necessary but it can paradoxically aggravate the patient outcome by increasing the risk of recurrence. Many perioperative factors have been shown to contribute to the dissemination of the tumor: surgery itself, stress, inflammation, pain, anaesthetic drugs, blood transfusion, etc. The type of anaesthesia chosen in the cancer patient could then be crucial and influence the evolution of the disease. Experimental, preclinical and retrospective studies have suggested that a regional anesthesia associated or not with a general anesthesia for carcinologic surgery might reduce the risk of cancer recurrence. This text reviews the factors promoting the recurrence of tumors after carcinologic surgery and the potential possibilities of protection associated with the type of anaesthesia chosen.
癌症的手术治疗通常是必要的，但矛盾的是，它可能会因增加复发风险而加重患者的预后。许多围手术期因素已被证明会导致肿瘤扩散：手术本身、应激、炎症、疼痛、麻醉药物、输血等。因此，癌症患者选择的麻醉类型可能至关重要，并会影响疾病的发展。实验、临床前和回顾性研究表明，癌症手术中采用的区域麻醉联合或不联合全身麻醉可能会降低癌症复发风险。本文综述了癌症手术后促进肿瘤复发的因素以及与所选麻醉类型相关的潜在保护可能性。
