tailieunhanh - báo cáo khoa học: "Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor | Kitchens et al. World Journal of Surgical Oncology 2011 9 11 http content 9 1 11 5 2 WORLD JOURNAL OF SURGICAL ONCOLOGY TECHNICAL INNOVATIONS Open Access Partial abdominal evisceration and intestinal autotransplantation to resect a mesenteric carcinoid tumor 12 3 2 2 William H Kitchens Nahel Elias Lawrence S Blaszkowsky A Benedict Cosimi Martin Hertl Abstract Background Midgut carcinoids are neuroendocrine tumors that commonly metastasize to the intestinal mesentery where they predispose to intestinal obstruction ischemia and or congestion. Because of their location many mesenteric carcinoid tumors are deemed unresectable due to the risk of uncontrollable bleeding and prolonged intestinal ischemia. Case Presentation We report the case of a 60-year-old male with a mesenteric carcinoid tumor obstructing his superior mesenteric vein resulting in intestinal varices and severe recurrent GI bleeds. While his tumor was thought to be unresectable by conventional techniques it was successfully resected using intestinal autotransplantation to safely gain access to the tumor. This case is the first described application of this technique to carcinoid tumors. Conclusions Intestinal autotransplantation can be utilized to safely resect mesenteric carcinoid tumors from patients who were not previously thought to be surgical candidates. We review the literature concerning both carcinoid metastases to the intestinal mesentery and the use of intestinal autotransplantation to treat lesions involving the mesenteric root. Background Carcinoid tumors are the most common neuroendocrine neoplasm typically arising in the respiratory and midgut gastrointestinal tracts 1 2 . While midgut carcinoid tumors are usually slow growing they are often associated with severe complications from early metastasis to the liver and the small bowel mesentery 3 . These mesenteric carcinoid tumors release serotonin and other growth factors which induce a desmoplastic reaction causing diffuse .