A prospective study of carcinoid crisis with no perioperativ
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Carcinoid crises, defined as the sudden onset of hemodynamic instability in patients with neuroendocrine tumors undergoing the operation, are associated with a significantly increased risk of postoperative complications. Octreotide has been used prophylactically to reduce crisis rates as well as therapeutically to treat crises that still occur.

Patients with neuroendocrine tumors undergoing operation between 2017 to 2020 with no perioperative octreotide were prospectively studied.

One hundred and seventy-one patients underwent 195 operations. The crisis was documented in 49 operations, with a mean duration of 3 minutes.

The crisis was more likely to occur in patients with small bowel primary tumors, older age, and carcinoid syndrome. Those with crises were more likely to have major postoperative complications.

Completely eliminating perioperative octreotide resulted in neither increased rate nor duration compared with previous studies using octreotide. researchers conclude perioperative octreotide use may be safely stopped, owing to inefficacy, though the need for an effective medication is clear given continued higher rates of complications.

Surgery
Source: https://doi.org/10.1016/j.surg.2021.03.063
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