Impact of Awake Breast Cancer Surgery on Postoperative Lymphocyte Responses

Gianluca Vanni, Marco Materazzo, Tommaso Perretta, Rosaria Meucci, Lucia Anemona, Chiara Buonomo, Mario Dauri, Alessandra Vittoria Granai, Maurizio Rho, Sara Ingallinella, Federico Tacconi, Vincenzo Ambrogi, Agostino Chiaravalloti, Orazio Schillaci, Giuseppe Petrella, Oreste Claudio Buonomo

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Surgical stress and anesthesia affect the patient's immune system. Analysis of the lymphocyte response after breast-conserving surgery was conducted to investigate the differences between effects after general and local anesthesia.

MATERIALS AND METHODS: Fifty-six patients with breast cancer were enrolled for BCS through local or general anesthesia. Total leukocytes, total lymphocytes, lymphocyte-subsets including CD3+, CD19+, CD4+, CD8+, CD16+CD56+ and CD4+/CD8+ ratio was examined at baseline and on postoperative days 1, 2 and 3.

RESULTS: Baseline data showed no statistical difference between the two groups. Within-group ANOVA test showed significant differences for total leukocyte count (p<0.001), total lymphocyte count (p=0.009) and proportion of natural-killer cells (p=0.01) in the control group. Between-group analysis showed lower median values of total lymphocytes in the awake surgery group on postoperative days 1, 2 and 3 (p=0.001, p=0.02 and p=0.01, respectively) when compared to the control group. Patients who underwent surgery under general anesthesia had higher total lymphocyte counts on postoperative day 2 (p=0.04).

CONCLUSION: In this randomized study, breast-conserving surgery plus local anesthesia had a lower impact on postoperative lymphocyte response when compared to the same procedure performed under general anesthesia.

Original languageEnglish
Pages (from-to)1879-1884
Number of pages6
JournalIn vivo (Athens, Greece)
Issue number6
Publication statusPublished - Oct 31 2019


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