title: Perianaesthetic risks and outcomes of abdominal surgery for metastatic carcinoid tumours.
abstract: Patients with metastatic carcinoid tumours often undergo surgical procedures to reduce the tumour burden and associated debilitating symptoms. These procedures and anaesthesia can precipitate a life-threatening carcinoid crisis. To assess perioperative outcomes, we studied retrospectively the medical records of adult patients from 1983 to 1996 who underwent abdominal surgery for metastatic carcinoid tumours. Preoperative risk factors, intraoperative complications and complications occurring in the 30 days after surgery were recorded. Perioperative complications or death occurred in 15 of 119 patients (12.6%, exact confidence interval 7.2-19.9). None of the 45 patients who received octreotide intraoperatively experienced intraoperative complications compared with eight of the 73 patients (11.0%) who did not receive octreotide (P=0.023). The presence of carcinoid heart disease and high urinary output of 5-hydroxyindoleacetic acid preoperatively were statistically significant risk factors for perioperative complications.
authors.affiliation: Perioperative Outcomes Group and Department of Anesthesiology, Mayo Medical School, Rochester, MN, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Kinney
authors.forename: M E
authors.initials: ME
authors.lastname: Warner
authors.forename: D M
authors.initials: DM
authors.lastname: Nagorney
authors.forename: J
authors.initials: J
authors.lastname: Rubin
authors.forename: D R
authors.initials: DR
authors.lastname: Schroeder
authors.forename: P M
authors.initials: PM
authors.lastname: Maxson
authors.forename: M A
authors.initials: MA
authors.lastname: Warner
mesh_terms: D000008:Abdominal Neoplasms / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002275:Carcinoid Heart Disease / Q000150:complications; D002276:Carcinoid Tumor / Q000556:secondary* / Q000601:surgery*; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000209:etiology; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D018931:Antineoplastic Agents, Hormonal; D006897:Hydroxyindoleacetic Acid; D015282:Octreotide