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Association between perioperative intraperitoneal local anaesthetic infusion and long‐term survival and cancer recurrence after colectomy: follow‐up analysis of a previous randomized controlled trial
Author(s) -
MacFater Wiremu S.,
Xia Weisi,
Barazanchi Ahmed W. H.,
MacFater Hoani S.,
Lightfoot Nicholas,
Svirskis Darren,
Kahokehr Arman A.,
Hill Andrew G.
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15753
Subject(s) - medicine , perioperative , surgery , placebo , colorectal cancer , anesthesia , randomized controlled trial , cancer , survival analysis , colectomy , alternative medicine , pathology
Background High concentrations of local anaesthetic have an anti‐proliferative effect on colonic cancer in vitro . Intraperitoneal local anaesthetic (IPLA) has shown analgesic benefit and improved recovery in the perioperative setting. The long‐term effects of IPLA in colon cancer resection have not been examined. This study aims to review the survival and oncological outcomes of a previously conducted trial that compared perioperative IPLA with placebo. Methods Sixty patients underwent colonic resection for benign and malignant disease as part of a double‐blinded, randomized, placebo‐controlled study between September 2008 and November 2009. The IPLA group received instillation of intraperitoneal ropivacaine before dissection followed by a 3‐day infusion. The placebo group was treated identically but with 0.9% saline solution. A follow‐up analysis was conducted to evaluate overall survival, disease‐free survival and recurrence specifically for patients undergoing resection for stages I–III colon cancer. Kaplan–Meier analysis was performed, and the log‐rank test was used to evaluate difference in survival between groups. Results Thirty‐seven of the 60 patients had stages I–III colon cancer and were included in this analysis. Nineteen patients were in the placebo group. There was no significant difference in overall survival or all‐cause mortality. There was a higher incidence of cancer‐specific mortality in the local anaesthetic group ( P < 0.046). Conclusion It does not appear that IPLA is associated with a significant survival benefit in patients with colonic malignancy undergoing colectomy. Other studies are needed to analyse the long‐term outcomes.