Update on carcinoid syndrome.

The carcinoid syndrome is a result of the release of multiple carcinoid tumor factors, particularly serotonin, kinins, and histamine. These factors cause flushing, hemodynamic instability, right-sided heart disease, bronchospasm, and gastrointestinal symptoms. A through preoperative assessment concentrating on these areas is necessary. The use of invasive monitors perioperatively, with the avoidance of drugs and techniques that can exacerbate the syndrome, is beneficial. Octreotide, both prophylactically and acutely, provides the best medical therapy available.