Yin Chengke, Sun Yiwu, Liang Jie, Sui Xin, He Zhaoyi, Song Ailing, Xu Wenjia, Zhang Lei, Sun Yufei, Zhao Jingshun, Han Fei
Department of Anesthesiology, Harbin Medical University Cancer Hospital, 150 Haping Rd, Nangang District, Harbin, Heilongjiang, 150081, China.
Department of Anesthesiology, Dazhou Central Hospital, 56 Nanyuemiao Rd, Tongchuan District, Dazhou, Sichuan, 635000, China.
BMC Cancer. 2025 Jan 6;25(1):13. doi: 10.1186/s12885-024-13413-0.
Different anesthetic drugs and techniques may affect survival outcomes for gastric cancer (GC) after surgery. In this study, we investigated the association between sedated and unsedated gastroscopy on survival outcomes in patients with GC after surgery.
This was a retrospective study of patients who were diagnosed with GC by gastroscopy and underwent gastrectomy from January 2013 to December 2017. They were grouped based on the examination modality: propofol-based sedated gastroscopy or unsedated gastroscopy. Propensity score matching (PSM) was used to balance the baseline variables. Survival outcomes and distant metastases were compared between these two groups.
Finally, 673 patients were enrolled, 160 in the sedated gastroscopy group and 513 in the unsedated gastroscopy group. After PSM, there were 160 patients in each group. There was no significant difference in overall survival outcomes in the sedated gastroscopy group compared to the unsedated gastroscopy group before PSM (HR = 0.761, 95% CI: 0.531-1.091, P = 0.139) or after PSM (HR = 0.874, 95% CI: 0.564-1.355, P = 0.547). There was no significant difference in the incidence of distant metastases between the two groups before PSM (16.9% vs. 20.7%, P = 0.294) or after PSM (16.9% vs. 23.8%, P = 0.126). To confirm that our patients behaved similarly to other studies, we performed a multivariate analysis and the results showed that sex, pathological TNM stage, Borrmann type, adjuvant treatment, and surgical resection range were all independent factors affecting survival outcomes in our patients.
Our results showed no significant difference in the effects of sedated gastroscopy vs. unsedated gastroscopy on survival outcomes or distant metastases of patients after gastrectomy for GC.
不同的麻醉药物和技术可能会影响胃癌（GC）手术后的生存结局。在本研究中，我们调查了镇静胃镜检查与非镇静胃镜检查对GC患者术后生存结局的影响。
这是一项对2013年1月至2017年12月期间经胃镜诊断为GC并接受胃切除术的患者进行的回顾性研究。根据检查方式将他们分组：丙泊酚镇静胃镜检查或非镇静胃镜检查。采用倾向评分匹配（PSM）来平衡基线变量。比较两组之间的生存结局和远处转移情况。
最终，共纳入673例患者，镇静胃镜检查组160例，非镇静胃镜检查组513例。PSM后，每组各有160例患者。在PSM之前，镇静胃镜检查组与非镇静胃镜检查组的总生存结局无显著差异（HR = 0.761，95%CI：0.531 - 1.091，P = 0.139）；PSM之后亦无显著差异（HR = 0.874，95%CI：0.564 - 1.355，P = 0.547）。两组在PSM之前远处转移发生率无显著差异（16.9%对20.7%，P = 0.294），PSM之后同样无显著差异（16.9%对23.8%，P = 0.126）。为证实我们的患者表现与其他研究相似，我们进行了多因素分析，结果显示性别、病理TNM分期、Borrmann分型、辅助治疗及手术切除范围均为影响我们患者生存结局的独立因素。
我们的结果表明，对于GC胃切除术后患者，镇静胃镜检查与非镇静胃镜检查对生存结局或远处转移的影响无显著差异。
