Perioperative care and cancer recurrence: Is there a connection?
Perioperative care and cancer recurrence: Is there a connection?作者机构：Cleveland Clinic Foundation Cleveland OH 44195 United States Department of Anesthesiology and Critical Care University of Pennsylvania Philadelphia PA 19104United States Anesthesiology Institute Cleveland Clinic FoundationClevelandOH 44195United States
出 版 物：《World Journal of Anesthesiology》 (世界麻醉学杂志)
年 卷 期：2014年第3卷第1期
页 面：31-45页
学科分类：10[医学]
主 题：Cancer Recurrence Survival Anesthesia Perioperative Factors
摘 要：Cancer is the second most common cause of death in the United States. Metastatic disease is a more important cause of cancer-related death relative to primary tumor progression. Surgical excision is the primary treatment for most malignant tumors. However, surgery itself can inhibit important host defenses and promote the development of metastases. An altered balance between the metastatic potential of the tumor and the anti-metastatic host defenses, including cellmediated immunity and natural killer cell function, is a plausible mechanism of increased cancer metastasis. This article reviews the increasingly recognized concept of anesthetic technique along with perioperative factors and their potential to affect long-term outcome after cancer surgery. The potential effect of intravenous anesthetics, volatile agents, local anesthetic drugs, opiates, and non-steroidal anti-inflammatory drugs are reviewed along with recent literature and ongoing clinical trials in this area. Regional anesthesia is increasingly emerging as a safer option with less cancer recurrence potential as compared to general anesthesia. Blood transfusion, pain, stress, use of beta-blockers, and hypothermia are other potentially important perioperative factors to consider.
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