Sjöblom S M, Höckerstedt K, Järvinen H
Second Department of Surgery, Helsinki University Central Hospital, Finland.
Acta Chir Scand. 1987 Sep;153(9):523-9.
Fourteen patients with carcinoid syndrome due to metastatic ileal (10), ileo-coecal (3) or appendiceal (1) carcinoid tumours were treated with hepatic dearterialization procedures: 15 surgical interruptions of arterial connections to the liver and 1 angiographic embolization of hepatic arteries. 11 patients had complained of recurrent attacks of flush, diarrhea and/or dyspnea and 3 patients had already progressed to general debility and cardiac failure caused by tumour products. Hepatic dearterialization abolished the carcinoid syndrome symptoms for 3-60 months (mean 19 months). Urinary 5-HIAA decreased for a mean period of 27 months. After relapsing symptoms 2 patients had redearterialization of the liver with a renewed symptomless period and lowered 5-HIAA excretion. Operative mortality was 19%: the deaths occurred when liver dearterialization was performed for end-stage patients or simultaneously with bowel resection, which should be considered as contraindications. Hepatic dearterialization seems to be temporarily effective in relieving carcinoid syndrome symptoms and in reducing hormonally active tumour mass and serotonin formation.
14例因转移性回肠类癌（10例）、回盲部类癌（3例）或阑尾类癌（1例）导致类癌综合征的患者接受了肝动脉去神经支配手术：15例通过手术中断肝脏的动脉连接，1例通过肝动脉造影栓塞术。11例患者曾抱怨有潮红、腹泻和/或呼吸困难的反复发作，3例患者已发展为因肿瘤产物导致的全身衰弱和心力衰竭。肝动脉去神经支配使类癌综合征症状消失3至60个月（平均19个月）。尿5-羟吲哚乙酸平均下降27个月。症状复发后，2例患者再次进行了肝脏动脉再通，症状再次消失，5-羟吲哚乙酸排泄降低。手术死亡率为19%：死亡发生在为终末期患者进行肝动脉去神经支配手术时，或与肠切除术同时进行时，这应被视为禁忌证。肝动脉去神经支配似乎在缓解类癌综合征症状、减少激素活性肿瘤肿块和血清素形成方面具有暂时的效果。
