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The aim of the study is a comparative study of the cellular immunity response of patients operated on for kidney cancer under total intravenous and inhalational anesthesia.
The severity of perioperative immunosuppression is directly proportional to the degree of surgical stress. A series of experimental and clinical studies indicate a different effect of certain types of anesthesia on immunity. It is believed that surgical stress itself opens an opportunity for the recurrence of oncological diseases precisely due to the immunosuppressive effect. The aim of present pilot clinical study is to test a hypothesis that total intravenous anesthesia as superior to inhalational anesthesia in term of its effects on cell immunity among patients with kidney cancer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| total intravenous anesthesia | Experimental | Patients, scheduled for nephrectomy for kidney cancer will receive neuraxial epidural block and propofol for perioperative anesthesia |
|
| Volatile anesthesia | Active Comparator | Patients, scheduled for nephrectomy for kidney cancer will receive neuraxial epidural block and sevoflurane for perioperative anesthesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Propofol | Drug | Propofol will be used for anesthesia during surgery |
| |
| Measure | Description | Time Frame |
|---|---|---|
| CD 16 | NK cells expression of CD16 receptor | postoperative day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| CD45 | CD45 expression on lymphocytes measured with flow cytometry | Baseline, end of surgery, postoperative days 1, 3-4, 7 |
| CD3 | CD3 expression on lymphocytes measured with flow cytometry |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| State Research Institute of Circulation Pathology | Novosibirsk | Russia |
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| ID | Term |
|---|---|
| D007680 | Kidney Neoplasms |
| ID | Term |
|---|---|
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D015742 | Propofol |
| D000077149 | Sevoflurane |
| D000767 | Anesthesia, Epidural |
| ID | Term |
|---|---|
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
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| Sevoflurane |
| Drug |
Sevoflurane will be used for anesthesia during surgery |
|
| Epidural block | Procedure | Epidural catheterization Th9-Th10, ropivacaine for perioperative analgesia |
|
| Baseline, end of surgery, postoperative days 1, 3-4, 7 |
| CD19 | CD19 expression on lymphocytes measured with flow cytometry | Baseline, end of surgery, postoperative days 1, 3-4, 7 |
| CD4 | CD4 expression on lymphocytes measured with flow cytometry | Baseline, end of surgery, postoperative days 1, 3-4, 7 |
| CD8 | CD8 expression on lymphocytes measured with flow cytometry | Baseline, end of surgery, postoperative days 1, 3-4, 7 |
| CD16 | CD16 expression on lymphocytes measured with flow cytometry | Baseline, end of surgery, postoperative days 1, 3-4, 7 |
| CD25 | CD25 expression on lymphocytes measured with flow cytometry | Baseline, end of surgery, postoperative days 1, 3-4, 7 |
| HLA-DR | HLA-DR expression on lymphocytes measured with flow cytometry | Baseline, end of surgery, postoperative days 1, 3-4, 7 |
| D052776 |
| Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |
| D006838 |
| Hydrocarbons |
| D009930 | Organic Chemicals |
| D008738 | Methyl Ethers |
| D004987 | Ethers |
| D006845 | Hydrocarbons, Fluorinated |
| D006846 | Hydrocarbons, Halogenated |
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |