Partial hepatic resections for metastatic neuroendocrine tumors: perioperative outcomes - 10/10/18
, David M. Nagorney, MD, Daniel F. Clark, BSN, CRNA, Travis D. O'Brien, BSN, CRNA, Jonathan D. Turner, BSN, CRNA, Mary E. Marienau, APRN, CRNA, PhD, Darrell R. Schroeder, MS, David P. Martin, MD, PhDAbstract |
Study objective |
Partial hepatic resection reduces tumor burden in patients with metastatic neuroendocrine tumors, thereby improving quality and length of life. These procedures can be challenging as well as life-threatening. Our aim was to evaluate our patients' perioperative outcomes and propose a definition for an intraoperative carcinoid crisis relevant to this surgery, given its unique surgical considerations.
Design |
Retrospective study.
Setting |
Mayo Clinic, Rochester, Minnesota.
Patients |
One hundred sixty-nine patients undergoing partial hepatic resection for metastatic neuroendocrine tumors between 1997 and 2015 were identified retrospectively from a surgical database at Mayo Clinic Rochester.
Interventions |
None.
Measurements |
Intraoperative carcinoid crisis for patients undergoing hepatic resection of neuroendocrine tumors was defined. Patients' medical records were reviewed and data were abstracted describing patient and procedural characteristics and perioperative outcomes.
Main results |
There were no documented cases of carcinoid crisis (0.0%, 95% C.I. 0.0% to 2.2%). One patient developed clinical findings of an emerging carcinoid crisis, but was successfully treated with doses of octreotide and findings resolved in <10 min. Prophylactically 500 μg octreotide was given subcutaneously in 77% (130/169) of patients preoperatively.
Conclusions |
There were no documented cases of carcinoid crisis (0.0%, 95% C.I. 0.0% to 2.2%). Adverse events were infrequent.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Intraoperative carcinoid crisis was clearly defined. |
• | Prophylactic octreotide was given to most patients. |
• | No documented cases of carcinoid crisis occurred. |
Keywords : Carcinoid tumor, Operative
Plan
| ☆ | Name and grant number for any financial support for the study: this publication [or project] was supported by funds from Mayo Foundation for Medical Education and Research and the CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Science (NCATS). Disclosures and funding sources: all authors receive salary support from Mayo Clinic. Synopsis for Table of Contents: One hundred sixty-nine patients underwent partial hepatic resection for metastatic neuroendocrine tumors at Mayo Clinic Rochester by one surgeon between 1997 and 2015, and their medical records were retrospectively reviewed. Perioperative outcomes, octreotide administration, and a proposed definition of intraoperative carcinoid crisis specifically applicable for patients undergoing partial hepatic resection are described. |
Vol 51
P. 93-96 - décembre 2018 Retour au numéro
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