Perianaesthetic risks and outcomes of abdominal surgery for metastatic carcinoid tumours

Patients with metastatic carcinoid tumours often undergo surgical procedure s to reduce the tumour burden and associated debilitating symptoms. These p rocedures and anaesthesia can precipitate a life-threatening carcinoid cris is. To assess perioperative outcomes, we studied retrospectively the medica l records of adult patients from 1983 to 1996 who underwent abdominal surge ry for metastatic carcinoid tumours. Preoperative risk factors, intraoperat ive complications and complications occurring in the 30 days after surgery were recorded. Perioperative complications or death occurred in 15 of 119 p atients (12.6%, exact confidence interval 7.2-19.9). None of the 45 patient s who received octreotide intraoperatively experienced intraoperative compl ications 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 uri nary output of 5-hydroxyindoleacetic acid preoperatively were statistically significant risk factors for perioperative complications.