PDF(Pubmed)
Abstract：
BACKGROUND: Carcinoid tumors are rare neuroendocrine malignancies presenting in an increasing number in our center. The incidence of carcinoid tumors is approximatively between 2.5 and 5 cases per 100,000 people of whom about 50% develop carcinoid syndrome. Once the carcinoid syndrome has developed, a carcinoid cardiomyopathy can occur. Carcinoid heart disease (CaHD) remains a serious and rare complication associated with a significant increase in morbidity and mortality. Although carcinoid tumors have been known and studied for several years, there are still scarce data on the anesthetic management and the peri operative period.
METHODS: We describe a case of a Caucasian 44-year-old woman with an unusual presentation of left CaHD with an ileal neuroendocrine tumor and liver metastases. Our preoperative somatostatin administration protocol, limit the cardiac damage. The maintenance of stable hemodynamics, the use of balanced anesthetic technique, all along with a good understanding of the pathology, played a major role in the successful management of anesthesia. This case report allows us to introduce our decision algorithm for the management of this type of pathology in our tertiary hospital, Cliniques Universitaires Saint-Luc.
CONCLUSIONS: Despite the paucity of data, anesthetic management of patients with carcinoid tumor can be safely performed with effective hemodynamic monitoring and a good understanding of the pathophysiology. Knowledge and application of a clear institutional algorithm for octreotide administration and multidisciplinary consultation at a referral center are essential for the management of these patients.
METHODS: We describe a case of a Caucasian 44-year-old woman with an unusual presentation of left CaHD with an ileal neuroendocrine tumor and liver metastases. Our preoperative somatostatin administration protocol, limit the cardiac damage. The maintenance of stable hemodynamics, the use of balanced anesthetic technique, all along with a good understanding of the pathology, played a major role in the successful management of anesthesia. This case report allows us to introduce our decision algorithm for the management of this type of pathology in our tertiary hospital, Cliniques Universitaires Saint-Luc.
CONCLUSIONS: Despite the paucity of data, anesthetic management of patients with carcinoid tumor can be safely performed with effective hemodynamic monitoring and a good understanding of the pathophysiology. Knowledge and application of a clear institutional algorithm for octreotide administration and multidisciplinary consultation at a referral center are essential for the management of these patients.
摘要：
背景：类癌是罕见的神经内分泌恶性肿瘤，在我们中心有越来越多的表现。类癌肿瘤的发病率约为每100,000人中2.5至5例,其中约50%发展为类癌综合征。一旦类癌综合征发展起来，可发生类癌心肌病。类癌心脏病（CaHD）仍然是一种严重且罕见的并发症，其发病率和死亡率显着增加。虽然类癌肿瘤已经被认识和研究了几年，关于麻醉管理和围手术期的数据仍然很少。
方法：我们描述了一例44岁的高加索女性，其异常表现为左侧CaHD，伴有回肠神经内分泌肿瘤和肝转移。我们的术前生长抑素给药方案，限制心脏损伤。维持稳定的血液动力学，使用平衡麻醉技术，同时对病理学有很好的理解，在麻醉的成功管理中发挥了重要作用。这个病例报告让我们介绍我们的决策算法在我们的三级医院的这种类型的病理的管理，圣吕克诊所大学。
结论：尽管数据很少，通过有效的血流动力学监测和对病理生理学的充分了解，可以安全地对类癌患者进行麻醉管理。在转诊中心的奥曲肽管理和多学科咨询的明确机构算法的知识和应用对于这些患者的管理至关重要。
方法：我们描述了一例44岁的高加索女性，其异常表现为左侧CaHD，伴有回肠神经内分泌肿瘤和肝转移。我们的术前生长抑素给药方案，限制心脏损伤。维持稳定的血液动力学，使用平衡麻醉技术，同时对病理学有很好的理解，在麻醉的成功管理中发挥了重要作用。这个病例报告让我们介绍我们的决策算法在我们的三级医院的这种类型的病理的管理，圣吕克诊所大学。
结论：尽管数据很少，通过有效的血流动力学监测和对病理生理学的充分了解，可以安全地对类癌患者进行麻醉管理。在转诊中心的奥曲肽管理和多学科咨询的明确机构算法的知识和应用对于这些患者的管理至关重要。
