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[围手术期肿瘤播散。1. 围手术期因素的影响]

[Perioperative tumour dissemination. 1. Influence of perioperative factors].

作者信息

Orozco H D, Garutti I, Moraga F J G, Sánchez-Pedrosa G

机构信息

Servicio de Anestesia y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, España.

出版信息

Rev Esp Anestesiol Reanim. 2012 May;59(5):259-66. doi: 10.1016/j.redar.2012.04.007. Epub 2012 May 31.

Abstract

There has been growing concern in the last few years on the effect of anaesthetic drugs used during oncological surgery could have on tumour progression in the long-term, as well as the influence of other perioperative factors. Although much of the available data has weak evidence, the role of the surgery itself, pain, transfusion of blood derivatives, etc., have been assessed in several studies. How some substances used during the anaesthetic process can influence tumour immune surveillance, cell proliferation or tumour angiogenesis processes have been observed in laboratory studies. The possible relevance of the anaesthetic technique used as regards the long-term tumour progression and survival is still to be determined. However, based on retrospective studies, it seems that those anaesthetic techniques combined with the use of regional anaesthesia and analgesia could be beneficial compared to those that are maintained on opioid use. Further research should help to elucidate the long-term clinical relevance of the perioperative procedures, including the anaesthetic, during oncological surgery.

摘要

在过去几年中,人们越来越关注肿瘤手术期间使用的麻醉药物对肿瘤长期进展的影响,以及其他围手术期因素的影响。尽管现有许多数据的证据不足,但手术本身、疼痛、血液制品输血等的作用已在多项研究中得到评估。在实验室研究中已经观察到麻醉过程中使用的一些物质如何影响肿瘤免疫监视、细胞增殖或肿瘤血管生成过程。所使用的麻醉技术与肿瘤长期进展和生存的可能相关性仍有待确定。然而,根据回顾性研究,与那些主要使用阿片类药物的麻醉技术相比,那些结合使用区域麻醉和镇痛的麻醉技术似乎更有益。进一步的研究应有助于阐明围手术期程序,包括肿瘤手术期间的麻醉,在临床上的长期相关性。

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