Effekt einer perioperativen Periduralanalgesie auf das Langzeitüberleben von Patienten nach Resektion eines kolorektalen Karzinoms

详细信息    查看全文

• 作者：J.P.N. Holler ; J. Ahlbrandt ; PD Dr. M. Gru? M.A. ; A. Hecker ; M.A. Weigand…
• 关键词：Periduralanalgesie ; Kolorektales Karzinom ; Chirurgie ; Langzeitüberleben ; Metaanalyse ; Peridural analgesia ; Colorectal cancer ; Surgery ; Long ; term survival ; Meta ; analysis
• 刊名：Der Chirurg
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：86
• 期：7
• 页码：655-661
• 全文大小：500 KB
• 参考文献：1.Antoni MH, Lutgendorf SK, Cole SW et al (2006) The influence of bio-behavioural factors on tumour biology: pathways and mechanisms. Nat Rev Cancer 6:240-48PubMed Central PubMed View Article <br>2.Bayer BM, Daussin S, Hernandez M et al (1990) Morphine inhibition of lymphocyte activity is mediated by an opioid dependent mechanism. Neuropharmacology 29:369-74PubMed View Article <br>3.Chapman CR, Tuckett RP, Song CW (2008) Pain and stress in a systems perspective: reciprocal neural, endocrine, and immune interactions. J Pain 9:122-45PubMed Central PubMed View Article <br>4.Chen WK, Miao CH (2013) The effect of anesthetic technique on survival in human cancers: a meta-analysis of retrospective and prospective studies. PLoS One 8:e56540PubMed Central PubMed View Article <br>5.Christopherson R, James KE, Tableman M et al (2008) Long-term survival after colon cancer surgery: a variation associated with choice of anesthesia. Anesth Analg 107:325-32PubMed View Article <br>6.Cummings KC III, Xu F, Cummings LC et al (2012) A comparison of epidural analgesia and traditional pain management effects on survival and cancer recurrence after colectomy: a population-based study. Anesthesiology 116:797-06PubMed View Article <br>7.Denis MG, Lipart C, Leborgne J et al (1997) Detection of disseminated tumor cells in peripheral blood of colorectal cancer patients. Int J Cancer 74:540-44PubMed View Article <br>8.Farooqui M, Li Y, Rogers T et al (2007) COX-2 inhibitor celecoxib prevents chronic morphine-induced promotion of angiogenesis, tumour growth, metastasis and mortality, without compromising analgesia. Br J Cancer 97:1523-531PubMed Central PubMed View Article <br>9.Forget P, Vandenhende J, Berliere M et al (2010) Do intraoperative analgesics influence breast cancer recurrence after mastectomy? A retrospective analysis. Anesth Analg 110:1630-635PubMed View Article <br>10.Gupta A, Bjornsson A, Fredriksson M et al (2011) Reduction in mortality after epidural anaesthesia and analgesia in patients undergoing rectal but not colonic cancer surgery: a retrospective analysis of data from 655 patients in central Sweden. Br J Anaesth 107:164-70PubMed View Article <br>11.Gupta K, Kshirsagar S, Chang L et al (2002) Morphine stimulates angiogenesis by activating proangiogenic and survival-promoting signaling and promotes breast tumor growth. Cancer Res 62:4491-498PubMed <br>12.Higgins JP, Altman DG, Gotzsche PC et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928PubMed Central PubMed View Article <br>13.Holler JP, Ahlbrandt J, Burkhardt E et al (2013) Peridural analgesia may affect long-term survival in patients with colorectal cancer after surgery (PACO-RAS-Study): an analysis of a cancer registry. Ann Surg 258:989-93PubMed View Article <br>14.Juni P, Witschi A, Bloch R et al (1999) The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 282:1054-060PubMed View Article <br>15.Liu SS, Carpenter RL, Mackey DC et al (1995) Effects of perioperative analgesic technique on rate of recovery after colon surgery. Anesthesiology 83:757-65PubMed View Article <br>16.Mann C, Pouzeratte Y, Boccara G et al (2000) Comparison of intravenous or epidural patient-controlled analgesia in the elderly after major abdominal surgery. Anesthesiology 92:433-41PubMed View Article <br>17.Merry AF, Webster CS, Mathew DJ (2001) A new, safety-oriented, integrated drug administration and automated anesthesia record system. Anesth Analg 93:385-90 (383rd contents page)PubMed <br>18.Moher D, Hopewell S, Schulz KF et al (2012) CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Int J Surg 10:28-5PubMed View Article <br>19.Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62:1006-012PubMed View Article <br>20.Myles PS, Peyton P, Silbert B et al (2011) Perioperative epidural analgesia for major abdominal surgery for cancer and recurrence-free survival: randomised trial. BMJ 342:d1491PubMed View Article <br>21.Neudecker J, Schwenk W, Junghans T et al (1999) Randomized controlled trial to examine the influence of thoracic epidural analgesia on postoperative ileus after laparoscopic sigmoid resection. Br J Surg 86:1292-295PubMed View Article <br>22.Nicholson G, Burrin JM, Hall GM (1998) Peri-operative steroid supplementation. Anaesthesia 53:1091-104PubMed View Article <br>23.Shavit Y, Depaulis A, Martin FC et al (1986) Involvement of brain opiate receptors in the immune-suppressive effect of morphine. Proc Natl Acad Sci U S A 83:7114-117PubMed Central PubMed View Article <br>24.Tabellini G, Borsani E, Benassi M et al (2014) Effects of opioid therapy on human natural killer cells. Int Immunopharmacol 18:169-74PubMed View Article <br>
• 作者单位：J.P.N. Holler (1) <br> J. Ahlbrandt (2) <br> PD Dr. M. Gru? M.A. (3) <br> A. Hecker (1) <br> M.A. Weigand (2) <br> W. Padberg (1) <br> R. R?hrig (4) <br><br>1. Klinik für Allgemein-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Justus-Liebig-Universit?t, Universit?tskliniken Gie?en und Marburg, Standort Gie?en, Gie?en, Deutschland <br> 2. Klinik für Anaesthesiologie, Operative Intensivmedizin und Schmerztherapie, Justus-Liebig-Universit?t, Universit?tskliniken Gie?en und Marburg, Standort Gie?en, Gie?en, Deutschland <br> 3. Klinik für Anaesthesiologie, operative Intensivmedizin und Schmerztherapie, Klinikum Hanau GmbH, Leimenstr. 20, 63450, Hanau, Deutschland <br> 4. Sektion Medizinische Informatik in Anaesthesiologie und Intensivmedizin, Klinik für Anaesthesiologie, Operative Intensvimedizin, Schmerztherapie, Justus-Liebig-Universit?t Gie?en, Gie?en, Deutschland <br>
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health<br>Surgery<br>Cardiac Surgery<br>Pediatric Surgery<br>Plastic Surgery<br>Traumatic Surgery<br>Vascular Surgery<br>
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-0385

文摘

Background The results of recent clinical studies suggest a potential benefit of peridural analgesia (PDA) during general anesthesia on long-term survival in patients after surgery for colorectal cancer. In order to test the hypothesis a meta-analysis was performed. Objectives To determine the prognostic impact of perioperative PDA on long-term survival in patients with colorectal cancer who underwent surgical resection. Material and methods By searching the relevant literature (up to May 2014) a total of 5 studies were identified from a total of 608 publications and a meta-analysis was carried out. Adjusted hazard ratios (HR) with 95- confidence intervals (CI) were used to assess the strength of associations. The random effects model was used to analyze the data and a modified forest plot was applied. Additionally, a potential publication bias was visually examined in a funnel plot. Results A positive association between PDA and improved long-term survival was observed in patients who underwent surgery for colorectal cancer without metastases (HR =-.81, 95- CI 0.68-.96, p--.055). Conclusion Despite a publication bias the use of PDA in patients who underwent surgery for colorectal cancer without metastases seemed to be advantageous. Randomized controlled trials are warranted to confirm the positive effects of additional PDA. The exact mechanisms of tumor suppressive effects of PDA have not yet been elucidated.