麻醉对癌症手术中长期生存的影响:系统性审查和元分析
Yaxing Tang1, Lele Tang1, Yuting Yao1
1Department of Anesthesiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Heliyon
|February 6, 2024
概括
与吸入麻醉相比,基于普罗波的麻醉可以改善癌症生存结果,包括整体存活率 (OS) 和无复发存活率 (RFS). 然而,这些好处主要出现在单中心研究中,需要进一步研究.
科学领域:
- 麻醉学和瘤学的麻醉学和瘤学
- 癌症手术的结果
- 药理学麻醉研究 药理学麻醉研究
背景情况:
- 麻醉类型对长期癌症患者存活率的影响受到争论.
- 在癌症手术中研究基于普罗波的与吸入麻醉的对比对于优化患者的治疗结果至关重要.
研究的目的:
- 评估基于普罗波的麻醉和吸入麻醉与癌症手术后的长期存活之间的关联.
- 根据麻醉类型,分析癌症患者的整体存活率 (OS) 和无复发存活率 (RFS).
主要方法:
- 一个系统的文献综述和对42个回顾性队列研究和2个RCT的元分析.
- 数据从PubMed,Medline,Embase和Cochrane图书馆收集到2023年11月15日.
- 使用随机效应模型计算了危险比率 (HR) 和95%置信区间 (CI).
主要成果:
- 与吸入麻醉相比,普罗波麻醉与改善的OS (HR=0.82) 和RFS (HR=0.80) 有关.
- 这些好处在单中心研究中显著,但在多中心研究中没有显著.
- 亚组分析显示,在肝胆道,妇科和骨肉瘤手术中,醇具有优势.
结论:
- 在特定的癌症手术中,基于普罗波的麻醉可以提供改善的生存益处.
- 由于研究设计的局限性和潜在的出版偏见,研究结果需要谨慎解释.
- 高质量的多中心随机对照试验对于验证这些结果至关重要.
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