eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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vol. 18

Anesthesia-related postoperative oncological surgical outcomes: a comparison of total intravenous anesthesia and volatile anesthesia. A meta-analysis

Qiaoqin Yan
Haofeng Liang
Hengming Yin
Xianhua Ye

Department of Anesthesiology, Wenling First People’s Hospital, Wenling Zhejiang, China
Department of Anesthesiology, The Fourth People’s Hospital of Nanning, Nanning, Guangxi Zhuang Autonomous Region, China
Department of Anesthesiology, Qinghai Provincial People’s Hospital, Xining Qinghai, China
Videosurgery Miniinv 2023; 18 (4): 612–624
Online publish date: 2023/12/27
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In patients undergoing cancer surgery, it is ambiguous whether propofol-based total intravenous anesthesia (TIVA) elicits a significantly higher overall survival rate than volatile anesthetics (VA). Consequently, evaluating the impact of TIVA and VA on long-term oncological outcomes is crucial.

This study compared TIVA versus VA for cancer surgery patients and investigated the potential correlation between anesthetics and their long-term surgical outcomes.

Material and methods
A comprehensive search of Medline, EMBASE, Scopus, and Cochrane Library identified English-language peer-reviewed journal papers. The statistical measurements of hazard ratio (HR) and 95% CI were calculated. We assessed heterogeneity using Cochrane Q and I2 statistics and the appropriate p-value. The analysis used RevMan 5.3.

The meta-analysis included 10 studies with 14036 cancer patients, 6264 of whom received TIVA and 7777 VA. In this study, we examined the long-term oncological outcomes of cancer surgery patients with TIVA and VA. Our data show that the TIVA group had a considerably higher overall survival rate (HR = 0.49, 95% CI: 0.30–0.80) and recurrence-free survival rate (HR = 0.56, 95% CI: 0.32–0.97). Each outcome was statistically significant (p < 0.05).

The present study concludes that TIVA is a more effective anesthetic agent than VA in obtaining better long-term oncological outcomes in cancer patients after surgery as it provides a higher overall survival rate, a higher recurrence-free survival rate and fewer post-operative pathological findings in patients who have undergone surgery for cancer as compared to VA.


cancer, mortality, volatile anesthetics, inhalation anesthetics, total intravenous anesthesia, balanced anesthesia

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