ABSTRACT. To investigate influence of general anesthesia on immunological anti-tumor activity, the natural killer (NK) cytotoxic activity of peripheral lymphocytes (PBLs) was measured in 7 dogs anesthetized for 3 hr with isoflurane following propofol-induction (anesthesia group) and 6 dogs without anesthesia (control group). Blood samples were collected before (baseline) and 24, 120 and 192 hr after the anesthesia. The PBLs were isolated via centrifugation with Ficoll-Hypaque solution (density, 1.073), and adherent cells were removed. The NK cytotoxic activity of the isolated PBLs against canine thyroid cancer cells was detected by the colorimetric rose Bengal assay. Significant decrease in the NK cytotoxic activity was observed at 24 hr after the anesthesia, compared with the baseline values and the control group. The NK cytotoxic activities were recovered to the baseline values until 120 hr after the anesthesia. The general anesthesia with isoflurane following propofol-induction decreased the NK cytotoxic activities of PBLs in dogs. This finding has a clinical relevance to the risk of tumor recurrence or metastasis induced by the suppression of immunological anti-tumor activity after general anesthesia in dogs. The results further emphasized the importance of the need to evaluate immune suppression following general anesthesia in animals.

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A 74-year-old female was diagnosed with hepatocellular carcinoma with tumor thrombus extending into the right atrium. She was scheduled to undergo hepatectomy and tumor thrombus removal with cardiopulmonary bypass.Starting cardiopulmonary bypass before attempting to resect her liver would reduce the risk of pulmonary embolism from tumor fragments, whereas concomitant heparin use might increase bleeding. After putting in the cigarette suture to enable starting the cardiopulmonary bypass at any time, hepatectomy was done before in this case.The operation was able to be finished safely while observing the tumor by echocardiography.