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Medicina perioperatoria in chirurgia oncologica in chiave PNEI: il ruolo delle strategie anestesiologiche su recupero e prognosi
Titolo Rivista: PNEI REVIEW 
Autori/Curatori: Davide Gottardello 
Anno di pubblicazione:  2018 Fascicolo: 2 Mente, cervello e salute Lingua: Italiano 
Numero pagine:  13 P. 104-116 Dimensione file:  1145 KB
DOI:  10.3280/PNEI2018-002008
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La patologia oncologica coinvolge l’individuo nella sua complessità di mente, corpo e relazioni. Dalla diagnosi e durante il periodo perioperatorio, il trauma chirurgico e le dinamiche psichiche attivano una risposta neuroendocrina con alterazioni metaboliche ed immunitarie, le quali possono impattare sul recupero delle funzioni organiche e mentali e probabilmente anche in termini di prognosi. La letteratura scientifica più recente sta offrendo nuove conoscenze e spunti di riflessione sugli effetti dell’interazione tra chirurgia e farmaci anestetici sui meccanismi immunologici e molecolari intracellulari. In un’ottica PNEI sarà possibile impostare un programma perioperatorio che consideri la possibilità di una preabilitazione preoperatoria, una scelta di tecniche chirurgiche e anestesiologiche più consapevole, un contenimento del catabolismo postoperatorio e una gestione dello stress psichico con tecniche per la mente. Il protocollo internazionale ERAS (enhanced recovery after surgery) viene portato come esempio di tentativo di incarnare nella pratica clinica una visione PNEI della medicina perioperatoria.

Keywords: Medicina perioperatoria, Anestesia, Preabilitazione, Meditazione, Immunonutrizione, ERAS.

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Davide Gottardello, in "PNEI REVIEW" 2/2018, pp. 104-116, DOI:10.3280/PNEI2018-002008


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