Abstract
The change of perioperative immune function in patients with esophageal cancer is mainly caused by the joint action of surgical trauma and anesthesia. In our study, we aimed to investigate the effects of different anesthetic methods on the changes of T lymphocyte subsets and cytokines in peripheral blood of patients with esophageal cancer surgery. 50 patients with esophageal cancer were divided into the study group and the control group. Among them, the patients in the control group chose intravenous anesthesia and received self-controlled intravenous analgesia after surgery. Patients in the study group chose thoracic epidural anesthesia combined with general anesthesia, undergoing self-controlled epidural analgesia after surgery; serum interleukin-2 (IL-2) and soluble interleukin-2 receptor (sIL-2R) were measured by ELISA. Serum stress hormones GH and sIL-8 were measured by radioimmunoassay. Both groups of patients achieved significant postoperative analgesia, but the VAS score in the study group at the T2–T4 time point was lower than that in the control group. The serum GH concentration in the study group increased at T1 and reached its highest peak at T2, then decreased. The serum IL-8 concentration of the two groups showed a downward trend from T1 to T4. Thoracic epidural anesthesia combined with general anesthesia for postoperative epidural analgesia can relieve the degree of cellular immunosuppression during and after surgery. Moreover, the thoracic epidural block combined with general anesthesia for esophageal cancer surgery and epidural analgesia after surgery for patients are anesthetic and analgesic methods with clinically significant effects. Our research results have a positive effect on the promotion of postoperative rehabilitation in patients with malignant cell tumors.
Highlights
Immune function is relatively important in tumor recurrence, metastasis, and prognosis in patients with malignant tumors
By performing an analgesic method for stable perioperative anesthesia in patients with malignant tumor surgery, it is possible to fundamentally improve the level of immune function of patients and alleviate or inhibit various harmful and irritating emergency reactions that may be caused by the body, which promotes patients with malignant cell tumors having a positive effect on postoperative rehabilitation [6, 7]. e emergency response induced by trauma in anesthetic surgery will gradually reduce the immune function of tumor patients [8–15]
In the comparison between groups, the CD4+% of the study group was higher than that of the control group at T1 to T4. e CD4+/CD8+ ratio of the study group was higher than that of the control group at T3 to T4. e comparison of CD8+ between the two groups at different time points had no statistical significance (P > 0.05; Figure 1)
Summary
Immune function is relatively important in tumor recurrence, metastasis, and prognosis in patients with malignant tumors. Patients with malignant tumors have a relatively low immune function, and major surgery, severe trauma, pain, and anesthesia may result in adverse effects on their immune function, causing severe stress response, unstable homeostasis, and metabolic disorders [1–5]. E emergency response induced by trauma in anesthetic surgery will gradually reduce the immune function of tumor patients [8–15]. Many reports have shown that surgical stress inhibition is mainly due to T lymphocyte-mediated cellular immunity, which has a direct impact on the incidence of postoperative infection and tumor metastasis [16, 17]. Because the degree of cellular immunosuppression during the perioperative period is mainly affected by the size and time of surgical trauma of patients, thoracotomy poses a greater impact on the patient’s respiratory and circulatory system [22]. Clinical surgery is more concerned with the patient’s stress response, especially in patients with esophageal cancer surgery [23–32]. is index has a certain reference value for the measurement of surgical trauma size
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