Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy
Autor: | Yi-Hsuan Huang, Kuen-Tze Lin, Meei-Shyuan Lee, Kuo-Chuan Hung, Yao-Tsung Lin, Zhi-Fu Wu, Hou-Chuan Lai, Jen-Yin Chen |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_treatment Cancer Treatment Metastasis Desflurane Postoperative Complications 0302 clinical medicine Anesthesiology 030202 anesthesiology Basic Cancer Research Medicine and Health Sciences Medicine Anesthesia Reproductive System Procedures Propofol Multidisciplinary Pharmaceutics Prostatectomy Prostate Cancer Hazard ratio Prostate Diseases Drugs Robotics Middle Aged Radical Prostatectomy Survival Rate Surgical Oncology Oncology 030220 oncology & carcinogenesis Anesthetics Inhalation Anesthetics Intravenous Research Article medicine.drug Clinical Oncology Biochemical recurrence Death Rates Urology Science Surgical and Invasive Medical Procedures 03 medical and health sciences Drug Therapy Population Metrics Humans Pain Management Survival rate Anesthetics Pharmacology Surgical Excision Population Biology business.industry Proportional hazards model Cancers and Neoplasms Biology and Life Sciences Genitourinary Tract Tumors Anesthetic Clinical Medicine business |
Zdroj: | PLoS ONE, Vol 15, Iss 3, p e0230290 (2020) PLoS ONE |
ISSN: | 1932-6203 |
Popis: | Background Previous researches have shown that anesthetic techniques may influence the patients' outcomes after cancer surgery. Here, we studied the relationship between the type of anesthetic techniques and patients' outcomes following elective robot-assisted radical prostatectomy. Methods This was a retrospective cohort study of patients who received elective, robot-assisted radical prostatectomy between January 2008 and December 2018. Patients were grouped according to the anesthesia they received, namely desflurane or propofol. A Kaplan-Meier analysis was conducted, and survival curves were presented from the date of surgery to death. Univariable and multivariable Cox regression models were used to compare hazard ratios for death after propensity matching. Subgroup analyses were performed for tumor-node-metastasis stage and disease progression. The primary outcome was overall survival, and the secondary outcome was postoperative biochemical recurrence. Results A total of 365 patients (24 deaths, 7.0%) under desflurane anesthesia, and 266 patients (2 deaths, 1.0%) under propofol anesthesia were included. The all-cause mortality rate was significantly lower in the propofol anesthesia than in the desflurane anesthesia during follow-up (P = 0.001). Two hundred sixty-four patients remained in each group after propensity matching. The propofol anesthesia was associated with improved overall survival (hazard ratio, 0.11; 95% confidence interval, 0.03-0.48; P = 0.003) in the matched analysis. Subgroup analyses showed that patients under propofol anesthesia had less postoperative biochemical recurrence than those under desflurane (hazard ratio, 0.20; 95% confidence interval, 0.05-0.91; P = 0.038) in the matched analysis. Conclusions Propofol anesthesia was associated with improved overall survival in robot-assisted radical prostatectomy compared with desflurane anesthesia. In addition, patients under propofol anesthesia had less postoperative biochemical recurrence. |
Databáze: | OpenAIRE |
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