Intraoperative end-tidal carbon dioxide levels are not associated with recurrence-free survival after elective pancreatic cancer surgery

• Verfasst von: Dehne, Sarah [VerfasserIn]
• Verfasst von: Kirschner, Lina [VerfasserIn]
• Verfasst von: Klotz, Rosa [VerfasserIn]
• Verfasst von: Kilian, Samuel [VerfasserIn]
• Verfasst von: Michalski, Christoph [VerfasserIn]
• Verfasst von: Hackert, Thilo [VerfasserIn]
• Verfasst von: Büchler, Markus W. [VerfasserIn]
• Verfasst von: Weigand, Markus A. [VerfasserIn]
• Verfasst von: Larmann, Jan [VerfasserIn]
• Titel: Intraoperative end-tidal carbon dioxide levels are not associated with recurrence-free survival after elective pancreatic cancer surgery
• Titelzusatz: a retrospective cohort study
• Verf.angabe: Sarah Dehne, Lina Kirschner, Rosa Klotz, Samuel Kilian, Christoph W. Michalski, Thilo Hackert, Markus W. Büchler, Markus A. Weigand and Jan Larmann
• E-Jahr: 2024
• Jahr: 11 September 2024
• Umfang: 9 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 21.11.2024
• Titel Quelle: Enthalten in: Frontiers in medicine
• Ort Quelle: Lausanne : Frontiers Media, 2014
• Jahr Quelle: 2024
• Band/Heft Quelle: 11(2024) vom: Sept., Artikel-ID 1442283, Seite 1-9
• ISSN Quelle: 2296-858X
• DOI: doi:10.3389/fmed.2024.1442283
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Carbon Dioxide
• Sach-SW: Oncological outcome
• Sach-SW: Pancreatic cancer surgery
• Sach-SW: perioperative complications
• Sach-SW: Recurrence-free survival
• K10plus-PPN: 1909325163
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

<sec><title>Background</title><p>Intraoperative end-tidal carbon dioxide concentrations (EtCO₂) values are associated with recurrence-free survival after colorectal cancer surgery. However, it is unknown if similar effects can be observed after other surgical procedures. There is now evidence available for target EtCO₂ and its relation to surgical outcomes following pancreatic cancer surgery.</p></sec><sec><title>Methods</title><p>In this single-center, retrospective cohort study, we analyzed 652 patients undergoing elective resection of pancreatic cancer at Heidelberg University Hospital between 2009 and 2016. The entire patient cohort was sorted in ascending order based on mean intraoperative EtCO₂ values and then divided into two groups: the high-EtCO₂ group and the low-EtCO2 group. The pre-specified primary endpoint was the assessment of recurrence-free survival up to the last known follow-up. Cardiovascular events, surgical site infections, sepsis, and reoperations during the hospital stay, as well as overall survival were pre-specified secondary outcomes.</p></sec><sec><title>Results</title><p>Mean EtCO₂ was 33.8 mmHg ±1.1 in the low-EtCO₂ group vs. 36.8 mmHg ±1.9 in the high-EtCO₂ group. Median follow-up was 2.6 (Q1:1.4; Q3:4.4) years. Recurrence-free survival did not differ among the high and low-EtCO₂ groups [HR = 1.043 (95% CI: 0.875-1.243), log rank test: <italic>p</italic> = 0.909]. Factors affecting the primary endpoint were studied via Cox analysis, which indicated no correlation between mean EtCO₂ levels and recurrence-free survival [Coefficient −0.004, HR = 0.996 (95% CI:0.95-1.04); <italic>p</italic> = 0.871]. We did not identify any differences in the secondary endpoints, either.</p></sec><sec><title>Conclusions</title><p>During elective pancreatic cancer surgery, anesthesiologists should set EtCO₂ targets for reasons other than oncological outcome until conclusive evidence from prospective, multicenter randomized controlled trials is available.</p></sec>