Effect Of Different Anesthetic Methods On CK20 MRNA、C Reactive Protein And Recurrence And Metastasis In Patients With Esophageal Cancer During Perioperative Period

ObjectivesTo investigate the effects of epidural anesthesia combined with general anesthesia and simple general anesthesia on CK20 mRNA,CRP and recurrence and metastasis in patients undergoing radical esophagectomy.MethodsA randomized controlled trial was conducted on patients undergoing radical resection of esophageal cancer in our hospital from 2014 to 2015.The subjects were randomly divided into two groups:group GE(epidural anesthesia combined with general anesthesia)and group GA(general anesthesia)with 91 cases in each group.The positive rate of CK20 mRNA and the content of CRP were recorded on the day of operation,the second day after operation and the seventh day after operation.Patients in the two groups were followed up for 3 years without disease.SPSS 19.0 statistical software was used to analyze the data and the difference was statistically significant(P<0.05).Results1.There was no significant difference in age,sex,body weight,BMI,ASA grade and operation time between the two groups(P>0.05),tthe dosage of anesthetic in group GE was significantly lower than that in group GA(P<0.05).2.There was no significant difference in postoperative histopathologic examination between the two groups(P>0.05).3.On the second day after operation,the CK20 mRNA,CRP of the two groups was significantly lower than that on the day of operation(P<0.05),the CK20 mRNA,CRP of group GE was significantly lower than that of the group GA on the second day after operation(P<0.05),and the CK20 mRNA,CRP of the two groups continued to decrease on the 7th day after operation.The positive rate of CK20 mRNA in group GE was significantly lower than that in group GA on the 7th day after operation(P<0.05).).4.All patients were followed up until May 31,2018,Median follow-up time of 45 months.Group GE was significantly higher than that of group GA(P<0.05).No statistical difference was found between the two groups(P>0.05).The disease-free survival time of group GE was significantly longer than that of group GA and had significant difference(P<0.05).There was no statistical difference in total survival time between the two groups(P>0.05).Conclusions1.Epidural anesthesia combined with general anesthesia can significantly reduce the dosage of anesthetic,the positive rate of CK20 mRNA and the content of CRP after radical resection of esophageal cancer.2.The 3-year disease-free survival rate and disease-free survival time of patients undergoing radical resection of esophageal carcinoma under epidural anesthesia combined with general anesthesia were significantly higher than those of patients undergoing radical resection of esophageal carcinoma under general anesthesiaThere was no statistical difference in the 3-year overall survival rate and total survival time between the two groups.3.Compared to general anesthesia,epidural anesthesia combined with general anesthesia may benefit patients with esophageal cancer after radical surgery.