Are we causing the recurrence-impact of perioperative period on long-term cancer prognosis: Review of current evidence and practice.
Are we causing the recurrence-impact of perioperative period on long-term cancer prognosis: Review of current evidence and practice.
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DOI：
10.4103/0970-9185.129996
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发表时间：
2014-04
期刊：
影响因子：
--
通讯作者：
Mehta Y
中科院分区：
文献类型：
--
作者：
Das J;Kumar S;Khanna S;Mehta Y
化疗药物方案、放射治疗和手术技术领域的新发展极大地改善了癌症患者的预后。如今，越来越多的侵袭性疾病患者接受手术切除。重建皮瓣手术的进步为患者提供了一个接近正常的有尊严的术后生活。因此，患者的期望值也在上升。肿瘤手术中已知的麻醉挑战包括气道困难、长时间手术期间血流动力学和温度的维持、疼痛管理和术后重症监护管理。但是，最近获得的数据表明，麻醉技术和围手术期的实施可能是原发肿瘤生长和可能复发的一个因素。这个概念的基础有些脆弱，没有确凿的证据支持。事实上，就像医学中任何其他有争议的话题一样，关于麻醉技术和药物有利作用的相互矛盾的报告在文献中比比皆是。这是我们文章的基础，我们分析了文献中现有的证据，以及这些和即将进行的大规模研究如何可能彻底改变肿瘤麻醉的实践。
Newer developments in the field of chemotherapeutic drug regimes, radiotherapy, and surgical techniques have improved the prognosis of cancer patients tremendously. Today increasing numbers of patients with aggressive disease are posted for surgical resection. The advances in reconstructive flap surgery offer the patient a near normal dignified postresection life. Hence, the expectations from the patients are also on the rise. Anesthetic challenges known in oncosurgery are that of difficult airway, maintenance of hemodynamics and temperature during long surgical hours, pain management, and postoperative intensive care management. But, recently acquired data raised the possibility of the anesthetic technique and conduct of perioperative period as a possible contributory factor in the growth and possible recurrence of the primary tumor. The foundation of the concept is somewhat fragile and not supported by conclusive evidence. In fact, like any other controversial topic in medicine, contradictory reports of the favorable effects of anesthetic technique and medications are plenty in the literature. This is the basis of our article where we have analyzed the current evidence available in the literature and how these and the forthcoming large scale studies may revolutionize the practice of oncoanesthesia.