Wang Z, Cheng JW, Yu KY. Short-term and long-term effects of sevoflurane inhalation vs propofol total intravenous anesthesia in gastrectomy for gastric cancer. World J Gastrointest Oncol 2025; 17(11): 109375 [DOI: 10.4251/wjgo.v17.i11.109375]
Corresponding Author of This Article
Kuai-Yun Yu, Department of General Surgery, Yantaishan Hospital, No. 91 Jiefang Road, Zhifu District, Yantai 264001, Shandong Province, China. 13853524166@163.com
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Oncology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 15, 2025 (publication date) through Nov 13, 2025
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World Journal of Gastrointestinal Oncology
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1948-5204
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Wang Z, Cheng JW, Yu KY. Short-term and long-term effects of sevoflurane inhalation vs propofol total intravenous anesthesia in gastrectomy for gastric cancer. World J Gastrointest Oncol 2025; 17(11): 109375 [DOI: 10.4251/wjgo.v17.i11.109375]
World J Gastrointest Oncol. Nov 15, 2025; 17(11): 109375 Published online Nov 15, 2025. doi: 10.4251/wjgo.v17.i11.109375
Short-term and long-term effects of sevoflurane inhalation vs propofol total intravenous anesthesia in gastrectomy for gastric cancer
Zhi Wang, Ji-Wen Cheng, Kuai-Yun Yu
Zhi Wang, Department of Anesthesiology, The Second Affiliated Hospital of Shandong First Medical University, Tai’an 271000, Shandong Province, China
Ji-Wen Cheng, Department of Oncology, Qingdao Municipal Hospital, Qingdao 266000, Shandong Province, China
Kuai-Yun Yu, Department of General Surgery, Yantaishan Hospital, Yantai 264001, Shandong Province, China
Author contributions: Wang Z designed the experiments and conducted clinical data collection; Cheng JW performed postoperative follow-up and recorded the data, conducted the collation and statistical analysis; Wang Z and Yu KY make critical revisions to important knowledge content; all authors read and approved the final manuscript.
Institutional review board statement: This study has been approved by the Ethics Committee of Yantaishan Hospital, No. 2024163.
Informed consent statement: The ethics committee of the institution agreed to waive informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kuai-Yun Yu, Department of General Surgery, Yantaishan Hospital, No. 91 Jiefang Road, Zhifu District, Yantai 264001, Shandong Province, China. 13853524166@163.com
Received: July 29, 2025 Revised: September 5, 2025 Accepted: October 13, 2025 Published online: November 15, 2025 Processing time: 107 Days and 17 Hours
Abstract
BACKGROUND
Gastric cancer is a major global health issue, and the perioperative period critically influences patient outcomes. The different effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on intraoperative stability, postoperative complications, and long-term oncologic outcomes in patients with gastric cancer undergoing radical gastrectomy remain unclear.
AIM
To compare the effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on clinical outcomes, including intraoperative indicators, postoperative complications, adverse effects, pain scores, and survival.
METHODS
This single-center retrospective cohort study included 204 patients who underwent radical gastrectomy for gastric cancer from February 2019 to December 2022. Patients were assigned to either the sevoflurane group (n = 103) or the propofol group (n = 101) based on intraoperative anesthetic regimen. Standardized protocols for anesthesia management, intraoperative monitoring, and postoperative analgesia were applied. Baseline characteristics; intraoperative metrics; adverse events; complications; Visual Analog Scale (VAS) scores at 2, 4, 6, 24, and 48 hours; and survival outcomes were retrospectively collected. Group comparisons were performed using χ2 for categorical variables, t test for continuous variables, and Kaplan-Meier analysis for survival outcomes.
RESULTS
Baseline demographic and clinical characteristics were similar between groups. No significant differences were observed in intraoperative indicators or most 30-day postoperative outcomes, including length of stay, emergency department visits, and readmission rates. The propofol group showed elevated mean VAS pain score at 24 hours postoperatively, but no differences were found at other time points. The propofol group also had significantly higher postoperative nausea incidence and transiently higher systolic/diastolic blood pressure and heart rate at the time of incision than the sevoflurane group. No significant differences were seen in overall rates or severity of postoperative complications, intraoperative adverse events, or in overall survival and progression-free survival.
CONCLUSION
In patients undergoing radical gastrectomy for gastric cancer, sevoflurane and propofol anesthesia demonstrated similar profiles regarding intraoperative safety, postoperative complications, adverse events, postoperative pain, and long-term survival. The selection of anesthesia can be personalized without significantly affecting perioperative or oncologic outcomes.
Core Tip: This study compares sevoflurane inhalation anesthesia with propofol total intravenous anesthesia in patients undergoing radical gastrectomy for gastric cancer. Both anesthetic techniques showed equivalent intraoperative safety and postoperative outcomes, including complications, pain scores, and long-term survival. Importantly, the propofol group exhibited higher postoperative nausea incidence and transiently elevated blood pressure and heart rate during surgery. These findings suggest that the choice of anesthetic can be individualized based on patient-specific factors without compromising perioperative or oncologic outcomes.
