Müge Çakırca, Semih Başkan, Mehmet Çakırca

Kolorektal Kanser Cerrahisi ve Rejyonel Anestezi

Kolorektal kanser görülme sıklığı yaşla artmaktadır. Geriatrik hastalarda kardiyorespiratuar ve serebrovasküler sistemlerde eşlik eden hastalıklar daha sık bulunmaktadır. Bu hastalarda yüksek ASA skorları, anatomik zorluklar ve cerrahi riskler anesteziyolojist tarafından yönetilmelidir.Anestetiklerin patofizyolojik etkilerinin daha iyi anlaşılmaya başlanması ile kolorektal kanser cerrahisi geçirecek hastaların anestezisini ve analjezisini sağlamakta rejyonel anestezi teknikleri kullanımı gündeme gelmiştir.Bu yazıda rejyonel anestezi tekniklerinin kolorektal kanser hastalarında uygulamalarının avantaj ve dezavantajları hakkında güncel bilgilerin sunulması amaçlanmıştır.

Anahtar Kelimeler:

rejyonel anestezi, kanser.

Regional Anesthesia and Colorectal Cancer Surgery

The incidence of colorectal cancer increase with age. Geriatric patients have more comorbid medical conditions including cardiorespiratory and cerebrovascular diseases. Thus, high ASA scores, anatomical deformities and surgical risks should be managed by anesthesiologists. More common using of regional anesthetic tecniques to provide anesthesia and analgesia fort he patients undergoing colorectal cancer surgery has became a current issue with the better understandings on the pathophysiologic effects of the anaesthetic agents.In this article, we aimed to discuss the advantages and disadvantages of regional anesthetic tecniques in patients undergoing colorectal cancer surgery.

Keywords:

regional anesthesia, cancer.,

PDF

___

Jemal A, Tiwari RC, Murray T, et al. Cancer statistics, 2004. CA Cancer J Clin 2004;54:8-29
Bresalier RS. Malignant neoplasms of the large intestine. In: Feldman M, Friedman LS, Sleisenger MH Editors. Gastrointestinal and liver disease, pathophysiology, diagnosis, management. Section ten. Small and large intestine.7th ed. Philadelphia. Saunders 2002;2215-62
Araz C. Kanser Hastalarında Anestezi. Anestezi Dergisi 2014;22:3-12
American Joint Committee on Cancer AHCC Cancer Staging Manual. 6th ed. New York: Springer, 2002:113-8
Gottschalk A, Ford JG, Regelin CC, et al. Association between Epidural Analgesia and Cancer Recurrence Colorectal Anesthesiology 2010;113:27-34 Cancer. Surgery
Gupta A, Fredriksson AB, Hallbo O, et al. Reduction in mortality after epidural anaesthesia and analgesia in patients undergoing rectal but not colonic cancer surgery: a retrospective analysis of data from 655 patients in Central Sweden. British Journal of Anaesthesia 2011;107:164-70
Sobrero A, Guglielmi A, Grossi F, et al. Mechanism of action of fluoropyrimidines:relevance to the new developments in colorectal cancer chemotherapy. Semin Oncol 2000;27:77-7
Bernold DM, Sinicrope FA. Advances in chemotherapy Gastroenterol Hepatol 2006;4:808-21 cancer. Clin
Skipworth J, Srilekha A, Raptis D, et al. Combined lumbar spinal and thoracic high-epidural regional anesthesia as an alternative to general anesthesia for high-risk patients undergoing gastrointestinal and colorectal surgery. World J Surg 2009;33:1809-14
Lassen K, Hannemann P, Ljungqvist O, et al. Enhanced Recovery After Surgery (ERAS) Group (2005). Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries. BMJ 330:1420-1
Basse L, Raskov HH, Hjort JD, et al. Accelerated postoperative recovery programme after colonic resection improves physical performance, pulmonary function and body composition. Br J Surg 2002;89:446-53
Basse L, Thorbol JE, Lossl K, et al. Colonic surgery with accelerated rehabilitation or conventional care. Dis Colon Rectum 2004;47:271-8
Lang M, Niskanen M, Miettinen P, et al. Outcome and resource utilization in gastroenterological surgery. Br J Surg 2001;88:1006-14
Nygren J, Hausel J, Kehlet H, et al. A comparison in five European centres of case mix, clinical management conventional or fast-track perioperative care in colorectal surgery. Clin Nutr 2005;24:455-61 either
Kyokong O, Charuluxananan S, Sriprajittichai P, et al. The incidence and risk factors of hypotension and bradycardia associated with spinal anaesthesia. J Med Assoc Thai 2006;89:58-64
Carpenter RL, Caplan RA, Brown DL, et al. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology 1993;78:402-3
Mannion S. Sedation, spinal anesthesia and older patients. J Postgrad Med 2007;53:155
Boztaş N, Birlik SÖ, Akan M, et al. Kolorektal Cerrahi Uygulanan Geriyatrik Bir Olguda Kombine Spinal Epidural Anestezi. DEÜ Tıp Fakültesi Dergisi 2011;25:113-7
Brittenden J, Heys SD, Ross J, et al. Natural killer cells and cancer. Cancer 1996;77:226-43
Benish M, Bartal I, Goldfarb Y, et al. Perioperative use of beta-blockers and COX-2 inhibitors may improve immune competence and reduce the risk of tumor metastasis. Ann Surg Oncol 2008;15:2042-52
Singleton PA, Lingen MW, Fekete MJ, et al. Methylnaltrexone inhibits opiate and VEGF-induced angiogenesis: Role of receptor transactivation. Microvasc Res 2006;72:3-11
Heaney DA, Buggy J. Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis? British Journal of Anaesthesia 2012;109:17-28
Biki B, Mascha E, Moriarty DC, et al. Anesthetic technique for radical prostatectomy surgery affects cancer Anesthesiology 2008;109:180-7 retrospective analysis.
Christopherson R, James KE, Tableman M, et al. Long-term survival after colon cancer surgery: A variation associated with choice of anesthesia. AnesthAnalg 2008;107:325-32
Exadaktylos AK, Buggy DJ, Moriarty DC, et al. Can anesthetic technique for primary breast cancer surgery Anesthesiology 2006;105:660-4 or metastasis?