scholarly journals Comparison of efficacy and safety of general anesthesia alone with those of combined epidural/general anesthesia in Chinese patients with gastric cancer undergoing laparoscopy-assisted tumor resection

2021 ◽  
Vol 20 (10) ◽  
pp. 2179-2185
Author(s):  
Hui Liu ◽  
Jie Wang ◽  
Hui Cao ◽  
Chao Zhang ◽  
Qingying Ma
Keyword(s):  
Gastric Cancer ◽  
Inflammatory Response ◽  
General Anesthesia ◽  
Early Stage ◽  
Tumor Resection ◽  
Survival Outcome ◽  
Opioid Consumption ◽  
Chinese Patients ◽  
General Anesthesia Group ◽  
Laparoscopic Assisted

Purpose: To compare postoperative opioid consumption, inflammatory response, survival/clinical outcomes and safety profile of epidural combined with general anesthesia (GA) versus GA in stage 1 gastric cancer patients undergoing surgical intervention by laparoscopy.Method: Chinese patients with early-stage gastric cancer undergoing laparoscopic-assisted tumor resection were enrolled and received either epidural combined with general anesthesia (group EA + GA) or general anesthesia only (group GA) in allocation ratio of 1:1. The following efficacy variables were assessed: 1) Pain score was measured on VAS scale; 2) post-operative consumption; 3) Quality of recovery; 4) inflammatory response; and 5) survival outcome. Safety was assessed throughout the study period.Results: Data for 200 subjects were analyzed. Compared to GA alone, combination of EA + GA demonstrate significantly greater reduction in post-operative pain with decrease postoperative opioid consumption. Also, the combination of GA and EA inhibited inflammatory response when compared to patients who received GA only. Moreover, the combination of GA and EA did not demonstrate any clinical benefit in survival outcome, when compared to patients who received GA alone, indicating that GA + EA has no role in improving survival outcome among patients undergoing gastric cancer surgery. Additionally, EA + GA was also associated with a shorter length of hospital stay, compared to GA.Conclusion: Overall, the results favor the use of GA + EA in Chinese patients with early-stage gastric cancer undergoing laparoscopic-assisted tumor resection. GA + EA combination improves immune response by inhibiting the inflammatory response but has no significant effect on survival outcome.

Multidisciplinary Approach in Improving Survival Outcome of Early-Stage Gastric Cancer

2020 ◽  
Vol 255 ◽  
pp. 285-296
Author(s):  
Xuefei Wang ◽  
Junjie Zhao ◽  
Zhenbin Shen ◽  
Mark Fairweather ◽  
Peter C. Enzinger ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multidisciplinary Approach ◽  
Early Stage ◽  
Survival Outcome

scholarly journals Inflammatory Profile of Awake Function-Controlled Craniotomy and Craniotomy under General Anesthesia

2009 ◽  
Vol 2009 ◽  
pp. 1-8 ◽  
Author(s):  
Markus Klimek ◽  
Jaap W. Hol ◽  
Stephan Wens ◽  
Claudia Heijmans-Antonissen ◽  
Sjoerd Niehof ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
General Anesthesia ◽  
Inflammatory Responses ◽  
Surgical Stress ◽  
Tumor Resection ◽  
Pain Anxiety ◽  
Emotional Challenge ◽  
Anesthesia Group ◽  
Patient Groups ◽  
Inflammatory Profile

Background. Surgical stress triggers an inflammatory response and releases mediators into human plasma such as interleukins (ILs). Awake craniotomy and craniotomy performed under general anesthesia may be associated with different levels of stress. Our aim was to investigate whether those procedures cause different inflammatory responses.Methods. Twenty patients undergoing craniotomy under general anesthesia and 20 patients undergoing awake function-controlled craniotomy were included in this prospective, observational, two-armed study. Circulating levels of IL-6, IL-8, and IL-10 were determined pre-, peri-, and postoperatively in both patient groups. VAS scores for pain, anxiety, and stress were taken at four moments pre- and postoperatively to evaluate physical pain and mental duress.Results. Plasma IL-6 level significantly increased with time similarly in both groups. No significant plasma IL-8 and IL-10 change was observed in both experimental groups. The VAS pain score was significantly lower in the awake group compared to the anesthesia group at 12 hours postoperative. Postoperative anxiety and stress declined similarly in both groups.Conclusion. This study suggests that awake function-controlled craniotomy does not cause a significantly different inflammatory response than craniotomy performed under general anesthesia. It is also likely that function-controlled craniotomy does not cause a greater emotional challenge than tumor resection under general anesthesia.

scholarly journals Combined anesthesia shows better curative effect and less perioperative neuroendocrine disorder than general anesthesia in early stage NSCLC patients

2019 ◽  
Vol 47 (10) ◽  
pp. 4743-4752
Author(s):  
Jingbo Pi ◽  
Yi Sun ◽  
Zhenghong Zhang ◽  
Chengfu Wan
Keyword(s):  
Adverse Events ◽  
General Anesthesia ◽  
Early Stage ◽  
Tumor Resection ◽  
Serum Levels ◽  
Control Group ◽  
Observation Group ◽  
Early Stage Nsclc ◽  
Tnf Α ◽  
Hs Crp

Objectives We aimed to compare the effects of general anesthesia with combined epidural and general anesthesia in patients with early-stage non-small cell lung carcinoma (NSCLC). Methods Patients scheduled to undergo tumor resection with adjuvant chemoradiotherapy were eligible. Patients in the control group received general anesthesia during surgery, and those in the observation group received combined epidural and general anesthesia. The hemodynamic factors mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, and oxygen saturation were measured. Serum levels of pro-inflammatory cytokines interleukin (IL)-1, IL-8, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor (TNF)-α as well as β-endorphin were measured by enzyme-linked immunosorbent assay. Serum malondialdehyde (MDA) was measured using the thiobarbituric acid method. Results The incidence of specific adverse events was reduced and overall and disease-free survival were improved in the observation group compared with the control group. MAP was generally lower in the observation group compared with the control group, as were the serum levels of IL-1, IL-8, hs-CRP, TNF-α, and MDA. Conclusions Compared with general anesthesia, combined epidural and general anesthesia may inhibit the occurrence of short-term adverse events and improve long-term outcomes by inhibiting inflammatory responses in patients with early-stage NSCLC after tumor resection.

scholarly journals Neutrophil-to-Lymphocyte Ratio Is a Useful Marker for Predicting Histological Types of Early Gastric Cancer

2021 ◽  
Vol 10 (4) ◽  
pp. 791
Author(s):  
Sho Yasui ◽  
Tomoaki Takata ◽  
Yu Kamitani ◽  
Yukari Mae ◽  
Hiroki Kurumi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Inflammatory Response ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Histological Assessment ◽  
Lymphocyte Ratio ◽  
Undifferentiated Adenocarcinoma ◽  
Grade Of Malignancy ◽  
The Relationship

Background: The indications for endoscopic submucosal dissection (ESD) for gastric cancer are based on preoperative histological assessment; however, examination of tissue biopsy is not always reliable as only a limited portion of the lesion can be obtained. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of inflammatory response and are potentially associated with the grade of malignancy in gastric cancer. We aimed to investigate the association between NLR and PLR and the histology of gastric cancer. Methods: This study included 218 patients who underwent ESD for gastric cancer. The relationship between NLR/PLR and histological diagnosis was investigated. Results: Patients with adenocarcinomas showed significantly higher NLR and PLR than those with adenomas (p < 0.001 and p < 0.05, respectively). Further, patients with undifferentiated adenocarcinoma showed a significantly higher NLR (p < 0.05) than those with differentiated adenocarcinoma. Conclusion: This study suggests that NLR could be a useful marker for assessing early gastric cancer.

scholarly journals IgG4-related gastric disease with plasma cell-rich obliterative arteritis accompanied by early-stage gastric cancer: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Masayoshi Obatake ◽  
Koichi Sato ◽  
Shigehiko Yagi ◽  
Hiromi Ohtani ◽  
Katsumi Kito
Keyword(s):  
Gastric Cancer ◽  
Plasma Cell ◽  
Early Stage ◽  
Vascular Lesions ◽  
Gastric Disease ◽  
Inflammatory Disorder ◽  
Obliterative Phlebitis ◽  
Regional Lymph Node Dissection ◽  
Serum Igg4 ◽  
Storiform Fibrosis

Abstract Background Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated inflammatory disorder that can involve multiple organs. It is characterized by IgG4-positive plasma cell-rich storiform fibrosis and obliterative phlebitis associated with a high serum IgG4 level. There are few reports of gastric IgG4-RD, especially those detected prior to systemic or other organ involvement. Case presentation: A 70-year-old man was diagnosed with type 0–IIc gastric cancer at the anterior wall of the gastric corpus by upper gastrointestinal endoscopy. In addition, a submucosal tumor (SMT) 7 mm in diameter was found at the greater curvature of the angulus. Laparoscopic distal gastrectomy with regional lymph node dissection was performed. Pathology revealed a poorly differentiated adenocarcinoma in the type 0–IIc lesion and storiform fibrosis with infiltration of a large number of IgG4-positive plasma cells in the SMT. Postoperative laboratory testing showed elevation of serum IgG4 levels; thus, we diagnosed the SMT as IgG4-RD. Intriguingly, the gastric IgG4-RD lesion demonstrated IgG4-positive plasma cell-rich arteritis as well as typical obstructive phlebitis. The patient has been followed for 2 years after surgery without recurrence of cancer, but skin lesions of IgG4-RD have appeared. Conclusion We report a rare case of IgG4-RD presenting as a gastric SMT, accompanied by early-stage gastric cancer. Our case may support a newly proposed relationship between IgG4-RD and malignancies. The gastric IgG4-RD lesion showed arteritis as well as obliterative phlebitis, potentially providing novel insight into IgG4-related vascular lesions.

Sign in / Sign up

Export Citation Format

Share Document