Abstract：
Carcinoid tumors are neuroendocrine tumors (NET) that secrete hormones and other substances into the circulation, causing shifts in hemodynamics and other unpleasant symptoms. This case report describes a case in which the patient had a midgut NET that metastasized to the liver, causing carcinoid syndrome. The patient underwent general anesthesia for an exploratory laparotomy, small bowel resection with anastomosis, mesenteric mass resection, and a right liver lobectomy. The patient had carcinoid syndrome and developed carcinoid crisis during the surgery. Octreotide and phenylephrine infusions and phenylephrine boluses were used during the procedure to stabilize hemodynamics. The pathophysiology of carcinoid tumors, carcinoid syndrome, carcinoid crisis, and carcinoid heart disease are reviewed and octreotide application in the setting of carcinoid syndrome and carcinoid crisis is also reviewed. Octreotide is a first-generation somatostatin analog that binds to somatostatin receptor 2 with high affinity, somatostatin receptor 3 and somatostatin receptor 5 with lower affinity, and suppresses the secretion of serotonin. Anesthesia recommendations are given for patients undergoing surgery with carcinoid syndrome.
摘要：
类癌是神经内分泌肿瘤（NET），分泌激素和其他物质进入循环，导致血流动力学改变和其他不愉快的症状。该病例报告描述了一个病例，其中患者有一个中肠网转移到肝脏，导致类癌综合征.患者接受了剖腹探查术的全身麻醉，小肠切除吻合,肠系膜肿块切除术,和右肝叶切除术.患者在手术过程中出现类癌综合征和类癌危象。在手术过程中使用奥曲肽和去氧肾上腺素输注和去氧肾上腺素推注以稳定血液动力学。类癌的病理生理学，类癌综合征,类癌危机，综述了类癌心脏病和奥曲肽在类癌综合征和类癌危象中的应用。奥曲肽是第一代生长抑素类似物，以高亲和力与生长抑素受体2结合，生长抑素受体3和生长抑素受体5亲和力较低，并抑制血清素的分泌。对类癌综合征手术患者给予麻醉建议。
