When performing surgery to remove a malignant tumor, will different anesthesia methods affect postoperative recovery?

Gao Xinyue, Department of Anesthesiology, Pudong New Area Punan Hospital, Shanghai

Once a patient is diagnosed with cancer or malignant tumor, the first thing people think about is how long the patient can live? The second thing people think about is whether they can have surgery? Surgery requires anesthesia. Have you ever thought about the impact of different anesthesia methods and drugs on the patient's recovery? If you only know that surgery can cure diseases, then please read the following introduction carefully, and you may have a deeper understanding of surgery and anesthesia.

For patients with malignant tumors, they are mainly concerned about whether the tumor will metastasize, recur, and the mortality rate. These factors directly affect the patient's health and life expectancy, that is, the clinical prognosis. These mainly depend on the balance between the body's anti-tumor ability and the proliferation and invasion ability of tumor cells. In the final analysis, it is a question of the size of the human immune system.

In the occurrence and development of tumors, a complete immune system is crucial to resist tumor metastasis, development and prognosis, and plays a dominant role. Impaired immune function can cause tumor recurrence or metastasis. Based on the existing research results, some anesthetic drugs and anesthesia methods may have an adverse effect on the immune function of patients with malignant tumors, increasing the risk of tumor recurrence and metastasis.

Domestic and foreign studies have shown that intravenous anesthetics can affect the progression of malignant tumors by affecting the function of the immune system. For example, some intravenous anesthetics can protect the immune system from suppression and inhibit the growth of tumor cells. A retrospective study believes that certain inhaled anesthetics promote tumor growth by inducing tumor cell self-renewal and proliferation, or have adverse effects by reducing human immunity. Most of the analgesics commonly used in anesthetics inhibit cellular immune function, and this inhibitory effect becomes more obvious as the dose increases. Fortunately, the most commonly used mainstream analgesics in the anesthesia department have a protective effect on the body's immunity.

There are different ways to classify anesthesia methods, such as general anesthesia and regional block anesthesia, and they can also be divided into intravenous anesthesia and inhalation anesthesia. The current mainstream view is that intravenous anesthesia suppresses the body's immune function less than inhalation anesthesia. A retrospective study reported that regional nerve block anesthesia can reduce the risk of tumor metastasis and recurrence, and when combined with general anesthesia, it can improve the clinical survival rate of tumor patients. This advantage is more obvious than simple general anesthesia, but there are also reports to the contrary from multicenter studies. Therefore, the mechanism of the influence of different anesthesia methods on tumor metastasis and prognosis has not been fully understood at present. Different research results have been obtained for different research subjects, and more high-quality multicenter, large-sample randomized controlled trials are needed to prove it.

At the end of this article, I would like to say that simply discussing the impact of anesthesia on the prognosis of patients with malignant tumors requires multi-faceted and multi-level arguments, and cannot be simply evaluated by good or bad, advantages or disadvantages. Although many research results in recent years have shown that anesthetic drugs have specific effects on the recurrence and metastasis of malignant tumors, there is still a lack of sufficient evidence to obtain clear conclusions or guidelines.

In any case, anesthesia definitely has an impact on the prognosis of patients with malignant tumors, the only difference is whether it is there or not, and whether it is big or small. To truly understand these issues, anesthesia experts need to conduct in-depth research on the biological relationship between anesthetic drugs and malignant tumors, the interaction during anesthesia, and the mechanism research at the cellular and molecular levels.

At the same time, in practical work, anesthesiologists need to optimize anesthesia plans, rationally use anesthetic drugs and superb anesthesia management skills (such as patient position, body temperature, infusion, blood transfusion, vital signs, anesthesia depth, water, electrolyte and acid-base balance and other internal environment regulation) according to the specific conditions of the patients. These methods are helpful to reduce postoperative tumor recurrence and metastasis and help improve the survival rate of patients with malignant tumors.

[Warm Tips] Follow us, there are a lot of professional medical knowledge here to help you understand the anesthesia issues in surgery~