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
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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