Gianluca Vanni1, Marco Materazzo2, Tommaso Perretta3, Rosaria Meucci3, Lucia Anemona4, Chiara Buonomo5, Mario Dauri5, Alessandra Vittoria Granai1, Maurizio Rho1, Sara Ingallinella1, Federico Tacconi6, Vincenzo Ambrogi6, Agostino Chiaravalloti7,8, Orazio Schillaci7,8, Giuseppe Petrella9, Oreste Claudio Buonomo1. 1. Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy. 2. Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy mrcmaterazzo@gmail.com. 3. Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Policlinico Tor Vergata University, Rome, Italy. 4. Anatomic Pathology, Department of Experimental Medicine, Policlinico Tor Vergata University, Rome, Italy. 5. Department of Emergency and Admission, Critical Care Medicine, Pain Medicine and Anesthetic Science, Policlinico Tor Vergata University, Rome, Italy. 6. Division of Thoracic Surgery, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy. 7. Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy. 8. IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy. 9. Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy.
Abstract
BACKGROUND: Surgical stress and anesthesia affect the patient's immune system. Analysis of the lymphocyte response after breast-conserving surgery was conducted to investigate the differences between effects after general and local anesthesia. MATERIALS AND METHODS:Fifty-six patients with breast cancer were enrolled for BCS through local or general anesthesia. Total leukocytes, total lymphocytes, lymphocyte-subsets including CD3+, CD19+, CD4+, CD8+, CD16+CD56+ and CD4+/CD8+ ratio was examined at baseline and on postoperative days 1, 2 and 3. RESULTS: Baseline data showed no statistical difference between the two groups. Within-group ANOVA test showed significant differences for total leukocyte count (p<0.001), total lymphocyte count (p=0.009) and proportion of natural-killer cells (p=0.01) in the control group. Between-group analysis showed lower median values of total lymphocytes in the awake surgery group on postoperative days 1, 2 and 3 (p=0.001, p=0.02 and p=0.01, respectively) when compared to the control group. Patients who underwent surgery under general anesthesia had higher total lymphocyte counts on postoperative day 2 (p=0.04). CONCLUSION: In this randomized study, breast-conserving surgery plus local anesthesia had a lower impact on postoperative lymphocyte response when compared to the same procedure performed under general anesthesia. Copyright
RCT Entities:
BACKGROUND: Surgical stress and anesthesia affect the patient's immune system. Analysis of the lymphocyte response after breast-conserving surgery was conducted to investigate the differences between effects after general and local anesthesia. MATERIALS AND METHODS: Fifty-six patients with breast cancer were enrolled for BCS through local or general anesthesia. Total leukocytes, total lymphocytes, lymphocyte-subsets including CD3+, CD19+, CD4+, CD8+, CD16+CD56+ and CD4+/CD8+ ratio was examined at baseline and on postoperative days 1, 2 and 3. RESULTS: Baseline data showed no statistical difference between the two groups. Within-group ANOVA test showed significant differences for total leukocyte count (p<0.001), total lymphocyte count (p=0.009) and proportion of natural-killer cells (p=0.01) in the control group. Between-group analysis showed lower median values of total lymphocytes in the awake surgery group on postoperative days 1, 2 and 3 (p=0.001, p=0.02 and p=0.01, respectively) when compared to the control group. Patients who underwent surgery under general anesthesia had higher total lymphocyte counts on postoperative day 2 (p=0.04). CONCLUSION: In this randomized study, breast-conserving surgery plus local anesthesia had a lower impact on postoperative lymphocyte response when compared to the same procedure performed under general anesthesia. Copyright
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