Outpatient breast-conserving surgery for breast cancer: Use of local and intravenous anesthesia and/or sedation may reduce recurrence and improve survival
| العنوان: | Outpatient breast-conserving surgery for breast cancer: Use of local and intravenous anesthesia and/or sedation may reduce recurrence and improve survival |
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| المؤلفون: | Ryungsa Kim, Koji Arihiro, Ami Kawai, Takanori Kin, Megumi Wakisaka, Sayaka Sawada, Mika Shimoyama, Naomi Yasuda |
| المصدر: | Annals of Medicine and Surgery |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | medicine.medical_specialty, Sedation, medicine.medical_treatment, Outpatient surgery, Anesthetic technique, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Breast-conserving surgery, medicine, Cohort Study, business.industry, Breast cancer recurrence, General Medicine, medicine.disease, Surgery, Radiation therapy, Intravenous anesthesia, 030220 oncology & carcinogenesis, Anesthetic, 030211 gastroenterology & hepatology, medicine.symptom, Complication, business, medicine.drug |
| الوصف: | Background The use of general anesthesia (GA) with inhalational anesthetics for breast cancer surgery may be associated with breast cancer recurrence and increased mortality due to the immunosuppressive effects of these drugs. Less-immunosuppressive anesthetic techniques may reduce breast cancer recurrence. We evaluated the feasibility, safety, and efficacy of outpatient breast-conserving surgery (BCS) for breast cancer in a breast clinic in terms of the anesthetic technique used, complications occurring, recurrence, and survival. Methods: The sample comprised 456 consecutive patients with stage 0–III breast cancer who underwent BCS/axillary lymph node (ALN) management using local and intravenous anesthesia and/or sedation between May 2008 and January 2020. Most patients received adjuvant chemotherapy and/or endocrine therapy and radiotherapy after surgery. Patient outcomes were evaluated retrospectively. Results: All patients recovered and were discharged after resting for 3–4 h postoperatively. No procedure-related severe complication or death occurred. Sixty-four complications (14.0%) were observed: 14 wound infections, 17 hematomas, and 33 axillary lymphoceles. The median follow-up period was 2259 days (range, 9–4190 days), during which disease recurrence was observed in 25 (5.4%) patients. The overall survival and breast cancer–specific survival rates were 92.3% and 94.7%, respectively. Conclusions: Outpatient surgery for breast cancer involving BCS and ALN management under local and intravenous anesthesia and/or sedation can be performed safely, without serious complication or death. Less-immunosuppressive anesthetic techniques with spontaneous breathing may reduce the recurrence of breast cancer and improve survival relative to GA. Highlights • Outpatient surgery for breast cancer involving breast-conserving surgery (BCS) and axillary lymph node (ALN) management under local and intravenous anesthesia and/or sedation can be performed safely. • Less-immunosuppressive anesthetic techniques with spontaneous breathing may reduce the recurrence of breast cancer and improve survival compared with general anesthesia. |
| تدمد: | 2049-0801 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a60d1e1503a724cdd66f0a520d604751 https://pubmed.ncbi.nlm.nih.gov/33224492 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....a60d1e1503a724cdd66f0a520d604751 |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 20490801 |
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