Early and Long-Term Outcomes after Propofol-and Sevoflurane-Based Anesthesia in Colorectal Cancer Surgery: A Retrospective Study

Journal of Clinical Medicine

MiHye Park¹  Woo Seog Sim¹  Seungwon Lee¹  Woo Young Lee²  Dae Hee Pyo² 

[1] Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea;Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;

关键词: colorectal cancer;    cancer resection;    cancer recurrence;    general anesthesia;    lymphocyte;    neutrophil;   

DOI  :  10.3390/jcm11092648

来源: DOAJ

【 摘 要 】

Background: Propofol is considered to protect against immunosuppression and has lower inflammatory responses in the perioperative period than volatile agents. We evaluated whether the anesthetic agent is associated with cancer outcomes. Methods: We retrospectively reviewed 2616 patients who underwent colorectal cancer surgery under general anesthesia between 2016 and 2018 (follow-up closure: July 2021) at a single institution. Patients received propofol-based total intravenous anesthesia or sevoflurane-based inhalational anesthesia. After propensity score matching, the postoperative neutrophil-lymphocyte ratio (NLR) was compared as primary outcome, and clinical outcomes were evaluated. Results: After 1:2 propensity matching, 717 patients were given propofol anesthesia and 1410 patients were given sevoflurane anesthesia. In the matched cohort, preoperative NLR was not significantly different between propofol and sevoflurane anesthesia (mean (95% CI)2.3 (1.8 to 2.8) and 2.2 (1.9 to 3.2); p = 0.72). NLR was significantly lower in propofol anesthesia at postoperative day two and five (mean difference (95% CI) 0.71 (0.43 to 0.98); p = 0.000 and 0.52 (0.30 to 0.74); p = 0.000). Urinary retention showed a higher incidence after propofol anesthesia (4.9% vs. 2.6%; p = 0.008). Other postoperative complications and overall/recurrence-free survival were not different in the two groups. Discussion: Although propofol anesthesia showed lower postoperative NLR than sevoflurane anesthesia, there was no association with clinical outcomes.

【 授权许可】

Unknown