Effects of different anesthesia method on short-term outcomes on gastric cancer through change of neutrophil to lymphocyte ratio

Abstract Background: Neutrophil to lymphocyte ratio (NLR) is an important indicator of patient prognosis. Different anesthesia method may improve the short-term prognosis of gastric cancer (GC) patients by affecting NLR. Methods: The authors collected the electronic medical records of patients who had undergone a GC resection from January 1, 2008 to December 31, 2011. Patients respectively received epidural combined general anesthesia (EGA) or general anesthesia (GA). Propensity score (PS) match was used to minimize differences. Manne Whitney U test was used to compare the effect of the two groups on postoperative Neutrophil to lymphocyte ratio (NLR), length of stay (LOS) and flatus time. Results: A total of 656 patients who had undergone gastric cancer resection were collected in this study, of which 608 patients were available (EGA group, n=221, GA group, n=387). After PS match ,203 patients were retained in each group. There were significant differences in postoperative NLR ( P =0.041), flatus time ( P =0.04), and LOS ( P <0.001) between EGA group and GA group after PS match. Conclusions: In conclusion, this study suggests that epidural anesthesia combined general anesthesia can improve the short-term prognosis of patients undergoing surgical resection of gastric cancer, which may be related to lower postoperative neutrophil to lymphocyte ratio.