Choi Hoon, Hwang Wonjung
Department of Anesthesia and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Front Surg. 2022 Jul 11;9:888630. doi: 10.3389/fsurg.2022.888630. eCollection 2022.
While surgical resection is the gold standard treatment for solid tumors, cancer recurrence after surgery is common. Immunosurveillance of remnant tumor cells is an important protective mechanism. Therefore, maintenance of anti-tumor cell activity and proper levels of inflammatory mediators is crucial. An increasing body of evidence suggests that surgery itself and perioperative interventions could affect these pathophysiological responses. Various factors, such as the extent of tissue injury, perioperative medications such as anesthetics and analgesics, and perioperative management including transfusions and methods of mechanical ventilation, modulate the inflammatory response in lung cancer surgery. This narrative review summarizes the pathophysiological mechanisms involved in cancer recurrence after surgery and perioperative management related to cancer recurrence after lung cancer surgery.
虽然手术切除是实体瘤的金标准治疗方法,但术后癌症复发很常见。对残留肿瘤细胞的免疫监视是一种重要的保护机制。因此,维持抗肿瘤细胞活性和适当水平的炎症介质至关重要。越来越多的证据表明,手术本身和围手术期干预可能会影响这些病理生理反应。各种因素,如组织损伤程度、围手术期用药(如麻醉剂和镇痛药)以及围手术期管理(包括输血和机械通气方法),都会调节肺癌手术中的炎症反应。本叙述性综述总结了术后癌症复发所涉及的病理生理机制以及与肺癌手术后癌症复发相关的围手术期管理。