影响结直肠癌手术预后因素的回顾性分析

被引:30
作者
袁友红 [1 ]
邢祖民 [1 ]
林春水 [2 ]
机构
[1] 南方医科大学南方医院
[2] 南方医科大学附属顺德第一人民医院
关键词
结直肠肿瘤; 回顾性; 分析; 预后; 麻醉;
D O I
暂无
中图分类号
R735.3 [肠肿瘤];
学科分类号
100112 [医学生物化学与分子生物学];
摘要
目的:探讨影响结直肠癌手术预后的因素及不同麻醉方法与术后生存率的关系。方法:回顾性分析我院1998年1月至2010年12月期间首次行结直肠癌根治术患者780例的临床及随访资料,其中完整随访共670例,对可能影响术后生存率的因素作COX回归分析,并对3种不同麻醉方法即硬膜外麻醉(E组)、全身麻醉(G组)和硬膜外复合全身麻醉(EG组)的生存率作比较分析。结果:T分期、淋巴结侵犯、麻醉方式、围术期输血、术后化疗、复发、远处转移和手术并发症是影响结直肠癌预后的独立危险因素。不同麻醉组的生存率有统计学差异(P=0.018)。G组和EG组术后生存率相比于E组的风险系数分别为0.623(95%CI0.430~0.902,P=0.012)和0.532(95%CI0.365~0.776,P=0.001),差异有统计学意义,E组生存率低于G组和EG组;EG组术后生存率相比于G组的风险系数为0.855(95%CI0.619~1.181,P=0.341),差异无统计学意义。结论:结直肠癌手术预后与T分期、淋巴结侵犯、麻醉方式、围术期输血、术后化疗、复发、远处转移和手术并发症密切相关。全身麻醉和硬膜外复合全身麻醉术后生存率均高于硬膜外麻醉,是结直肠癌患者手术的合适麻醉方法。
引用
收藏
页码:2912 / 2915
页数:4
相关论文
共 11 条
[1]
芬太尼对人胃癌MGC-803细胞活力的影响题录附视频 [J].
覃怡 ;
利莉 ;
陈静 ;
谢玉波 .
中华麻醉学杂志, 2010, (06)
[2]
麻醉与术后镇痛方法对老年直肠癌患者T细胞亚群的影响 [J].
李雅兰 ;
陈云波 ;
莫世湟 ;
彭雪梅 ;
王小平 ;
周长忍 .
中国病理生理杂志, 2007, (06) :1074-1078
[3]
Anesthetic technique for radical prostatectomy surgery affects cancer recurrence - A retrospective analysis [J].
Biki, Barbara ;
Mascha, Edward ;
Moriarty, Denis C. ;
Fitzpatrick, John M. ;
Sessler, Daniel I. ;
Buggy, Donal J. .
ANESTHESIOLOGY, 2008, 109 (02) :180-187
[4]
Long-Term Survival After Colon Cancer Surgery: A Variation Associated with Choice of Anesthesia.[J].Rose Christopherson;Kenneth E. James;Mara Tableman;Prudence Marshall;Frank E. Johnson.Anesthesia & Analgesia.2008, 1
[5]
Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis? [J].
Exadaktylos, Aristomenis K. ;
Buggy, Donal J. ;
Moriarty, Denis C. ;
Mascha, Edward ;
Sessler, Daniel I. .
ANESTHESIOLOGY, 2006, 105 (04) :660-664
[6]
Potential prophylactic measures against postoperative immunosuppression: Could they reduce recurrence rates in oncological patients? [J].
Shakhar, G ;
Ben-Eliyahu, S .
ANNALS OF SURGICAL ONCOLOGY, 2003, 10 (08) :972-992
[7]
Natural killer cell activity and distant metastasis in rectal cancers treated surgically with and without neoadjuvant chemoradiotherapy [J].
Koda, K ;
Saito, N ;
Oda, K ;
Seike, K ;
Kondo, E ;
Ishizuka, M ;
Takiguchi, N ;
Miyazaki, M .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2003, 197 (02) :254-260
[8]
The in vivo effects of general and epidural anesthesia on human immune function [J].
Procopio, MA ;
Rassias, AJ ;
DeLeo, JA ;
Pahl, J ;
Hildebrandt, L ;
Yeager, MP .
ANESTHESIA AND ANALGESIA, 2001, 93 (02) :460-465
[9]
Attenuation of the tumor-promoting effect of surgery by spinal blockade in rats [J].
Bar-Yosef, S ;
Melamed, R ;
Page, GG ;
Shakhar, G ;
Shakhar, K ;
Ben-Eliyahu, S .
ANESTHESIOLOGY, 2001, 94 (06) :1066-1073
[10]
Effects of morphine on immune response in rats with sciatic constriction injury [J].
Tsai, YC ;
Won, SJ ;
Lin, MT .
PAIN, 2000, 88 (02) :155-160