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Beyond Pain Control: Exploring Regional Anaesthesia's Potential to Improve Gastric Cancer Surgery Survival Rates: A Retrospective Cohort Study

tatsuki, o.; onishi, y.

2024-01-13 anesthesia
10.1101/2024.01.12.24301216 medRxiv
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BackgroundGastric cancer management remains fraught with high morbidity and mortality rates owing to surgical interventions. Postoperative complications and extended hospitalisation profoundly affect patient survival, with elderly and medically compromised patients facing greater risks. We hypothesised that regional anaesthesia may reduce the surgical stress response and thus mortality. Hence, this study was aimed at investigating whether adjunctive application of regional anaesthesia during gastric cancer surgery attenuates the stress response to surgery, thereby improving postoperative survival outcomes. MethodsIn this study, we critically examined the potential role of regional anaesthesia in modulating perioperative immune and inflammatory responses, which are vital for improving oncological outcomes. Previous studies using diverse methodologies have provided heterogeneous and inconclusive results regarding the effectiveness of regional anaesthesia in enhancing cancer-related survival. Our study addresses these inconsistencies using a robust research design that was focused on a well-defined patient cohort. ResultsPreliminary evidence suggests that regional anaesthesia can modulate immune responses. However, its clinical benefits in cancer recurrence and survival have not been consistently demonstrated. The extant literature reflects a gap between preclinical promise and clinical efficacy, with no substantial evidence supporting a reduction in cancer recurrence after gastroesophageal cancer surgery under regional anaesthesia. ConclusionThis study provides new insights into the role of regional anaesthesia in reducing the overall mortality in gastric cancer surgery. By employing stringent inclusion criteria and a well-defined patient cohort, this study aimed to provide clarity in a field marked by inconclusive evidence and guide future clinical practices and high-quality research initiatives.

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