Meta-analysis of the effects of total intravenous anesthesia and inhalation anesthesia on early postoperative immune function, recurrence and metastasis in patients with malignant tumors / 中国医师进修杂志

ABSTRACT

Objective:To compare the effects of total intravenous anesthesia and inhalation anesthesia on early postoperative immune function, recurrence and metastasis by Meta-analysis in patients with malignant tumors.Methods:The PubMed, Embase and Cochrane Library were searched by computer from January 2010 to January 2020. The randomized controlled trials of surgical treatment using total intravenous anesthesia or inhalation anesthesia in patients with malignant tumors were collected. The RevMan 5.3 and STATA 15.0 softwares were used to analyze the impact of 2 anesthesia methods on early postoperative immune function indexes and tumor recurrence and metastasis in patients with malignant tumors. The immune function indexes included interleukin (IL)-6, IL-10, transforming growth factor (TGF)-β, vascular endothelial growth factor (VEGF)-C and natural killer (NK) cell.Results:A total of 8 articles were included, with a total of 665 patients. Meta analysis results show that, compared with inhalation anesthesia, total intravenous anesthesia could significantly reduce the levels of IL-6, TGF-β and VEGF-C in patients with malignant tumors after surgery ( SMD = - 0.35, - 0.26 and - 0.64; 95% CI - 0.58 to - 0.12, - 0.49 to - 0.02 and - 0.99 to - 0.28; P<0.01 or <0.05); the 2 anesthesia methods had no significant effect on IL-10 and NK cell in patients with malignant tumors after surgery ( SMD = 0.16 and 0.18, 95% CI - 0.07 to 0.39 and - 0.23 to 0.60, P>0.05); and the 2 anesthesia methods had no significant effect on tumor recurrence and metastasis in patients with malignant tumors ( RR = 0.70, 95% CI 0.47 to 1.03, P = 0.07). Conclusions:Total intravenous anesthesia may improve the early postoperative immune function in patients with malignant tumor by reducing the levels of pro-cancer factors IL-6, TGF-β and VEGF-C, but total intravenous anesthesia has no obvious effect on reducing postoperative tumor recurrence and metastasis in patients with malignant tumor.