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Total Intravenous Anesthesia and Acute Normovolemic Hemodilution for Sarcoma Surgery

Despite optimal local control for high-risk soft tissue sarcomas (STS) with radiation and surgery, there are no other interventions that clearly and significantly reduce the risk of distant relapse after resection. Cytotoxic chemotherapy for localized STS is controversial and is associated with sign...

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Autores principales: Ng, Vincent Y, Hollander, Kimberly N, Carr, Shamus R, Tanaka, Kenichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717086/
https://www.ncbi.nlm.nih.gov/pubmed/33282594
http://dx.doi.org/10.7759/cureus.11319
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author Ng, Vincent Y
Hollander, Kimberly N
Carr, Shamus R
Tanaka, Kenichi
author_facet Ng, Vincent Y
Hollander, Kimberly N
Carr, Shamus R
Tanaka, Kenichi
author_sort Ng, Vincent Y
collection PubMed
description Despite optimal local control for high-risk soft tissue sarcomas (STS) with radiation and surgery, there are no other interventions that clearly and significantly reduce the risk of distant relapse after resection. Cytotoxic chemotherapy for localized STS is controversial and is associated with significant side effects. There are significant biologic perturbations that occur at the time of operation and numerous studies have demonstrated that surgical removal of the primary tumor can accelerate the growth of subclinical metastases. While the exact etiology of this phenomenon is unknown, there is some evidence to suggest that allogeneic blood transfusion and volatile inhaled anesthetics may be associated with tumor-promoting processes. At our institution, we have utilized acute normovolemic hemodilution and total intravenous propofol-based anesthesia to avoid these potentially detrimental factors. 
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spelling pubmed-77170862020-12-05 Total Intravenous Anesthesia and Acute Normovolemic Hemodilution for Sarcoma Surgery Ng, Vincent Y Hollander, Kimberly N Carr, Shamus R Tanaka, Kenichi Cureus Anesthesiology Despite optimal local control for high-risk soft tissue sarcomas (STS) with radiation and surgery, there are no other interventions that clearly and significantly reduce the risk of distant relapse after resection. Cytotoxic chemotherapy for localized STS is controversial and is associated with significant side effects. There are significant biologic perturbations that occur at the time of operation and numerous studies have demonstrated that surgical removal of the primary tumor can accelerate the growth of subclinical metastases. While the exact etiology of this phenomenon is unknown, there is some evidence to suggest that allogeneic blood transfusion and volatile inhaled anesthetics may be associated with tumor-promoting processes. At our institution, we have utilized acute normovolemic hemodilution and total intravenous propofol-based anesthesia to avoid these potentially detrimental factors.  Cureus 2020-11-03 /pmc/articles/PMC7717086/ /pubmed/33282594 http://dx.doi.org/10.7759/cureus.11319 Text en Copyright © 2020, Ng et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Anesthesiology
Ng, Vincent Y
Hollander, Kimberly N
Carr, Shamus R
Tanaka, Kenichi
Total Intravenous Anesthesia and Acute Normovolemic Hemodilution for Sarcoma Surgery
title Total Intravenous Anesthesia and Acute Normovolemic Hemodilution for Sarcoma Surgery
title_full Total Intravenous Anesthesia and Acute Normovolemic Hemodilution for Sarcoma Surgery
title_fullStr Total Intravenous Anesthesia and Acute Normovolemic Hemodilution for Sarcoma Surgery
title_full_unstemmed Total Intravenous Anesthesia and Acute Normovolemic Hemodilution for Sarcoma Surgery
title_short Total Intravenous Anesthesia and Acute Normovolemic Hemodilution for Sarcoma Surgery
title_sort total intravenous anesthesia and acute normovolemic hemodilution for sarcoma surgery
topic Anesthesiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7717086/
https://www.ncbi.nlm.nih.gov/pubmed/33282594
http://dx.doi.org/10.7759/cureus.11319
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