Perioperative changes in pro and anticoagulant factors in prostate cancer patients undergoing laparoscopic and robotic radical prostatectomy with different anaesthetic techniques

Journal of Experimental & Clinical Cancer Research

Ester Forastiere⁴  Luigi Tomao³  Isabella Sperduti²  Valeria Gianaroli⁴  Giulia Torregiani⁴  Ilaria Monteferrante⁴  Claudia Claroni⁴  Rocco Papalia¹  Chiara Mandoj³  Michele Gallucci¹  Anna Antenucci³  Maria Sofra⁴ 

[1] Department of Urology, Regina Elena, Roma National Cancer Institute, Rome, Italy;Division of Biostatistic, Regina Elena, Roma National Cancer Institute, Rome, Italy;Clinical Pathology, Regina Elena, Roma National Cancer Institute, Rome, Italy;Department of Anaesthesiology, Regina Elena, Roma National Cancer Institute, Via Elio Chianesi 53, Roma 00144, Italy

关键词: Prostatectomy;    Prostate cancer;    Thrombotic factors;    BAL anaesthesia;    TIVA-TCI anaesthesia;   

Others  :  1136168
DOI  :  10.1186/s13046-014-0063-z

 received in 2014-04-04, accepted in 2014-07-15,  发布年份 2014

【 摘 要 】

Background

Laparoscopic prostatectomy (LRP) may activate clotting system influencing the risk of perioperative thrombosis in patients with prostate cancer. Moreover, different anaesthetic techniques can also modify coagulant factors. Thus, the aim of this study was to investigate the effects on pro- and anti-coagulant and fibrinolytic factors of two established types of anaesthesia in patients with prostate cancer undergoing elective LRP.

Methods

102 patients with primary prostate cancer, who underwent conventional LRP or robot-assisted laparoscopic prostatectomy (RALP), were studied and divided into 2 groups to receive total intravenous anesthesia with target-controlled infusion (TIVA-TCI) or balanced inhalation anaesthesia (BAL) prior to surgery. Before the induction of anaesthesia (T0), 1 hr (T1) and 24 hrs post-surgery (T2), some pro-coagulant factors, fibronolysis markers, p-selectin and haemostatic system inhibitors were evaluated.

Results

Both TIVA-TCI and BAL patients showed a marked and significant increase in pro-coagulant factors and consequent reduction in haemostatic system inhibitors in the early post operative period (p ≤ 0.004 for each markers). Use of RALP showed a significant increase in prothrombotic markers as compared to LRP. In TIVA patients undergoing LRP, a significant reduction of p-selectin levels between T0 and T2 (p = 0.001) was observed as compared to BAL, suggesting a better protective effect on platelet activation of anaesthetic agents used for TIVA.

Conclusions

Both anaesthetic techniques significantly seem to increase the risk of thrombosis in prostate cancer patients undergoing LRP, mainly when the robotic device was utilized, encouraging the use of a peri-operative thromboembolic prophylaxis in these patients.

【 授权许可】

   
2014 Sofra et al.; licensee BioMed Central Ltd.

【 图 表 】

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