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Portal vein involvement by carcinoid tumors is relatively rare. The extent of involvement has a significant effect on the type of surgical approach used. We reviewed our experience with type I gastric carcinoid tumors to determine the role of the midhepatic portal vein in this type of carcinoid tumor. The records of all patients with gastric carcinoid tumors who underwent operation for this diagnosis at our institution between January 1998 and December 2006 were reviewed. Demographic and clinical data were collected. We analyzed the type of surgical approach used for resection of the tumor. A total of 38 patients with gastric carcinoid tumors were identified. There were 18 female and 20 male patients. The median age was 46 years (range, 20-75 years). The median tumor size was 5.8 cm (range, 2.0-15.0 cm). A total of 43.7% of patients had tumor markers positive. A total of 68.4% of patients underwent a partial gastrectomy and 31.6% a total gastrectomy. Of the 43.7% of patients with positive tumor markers, 44.2% had a positive surgical margin. Of the 31.6% of patients who underwent a total gastrectomy, 27.9% had positive margins. There were no postoperative deaths. The mean hospitalization time was 16 days. The median follow-up was 27 months (range, 2-145 months). A total of 39.5% of patients had a recurrence of disease. There was no statistically significant difference between the mean diameter of the tumor and the margin status. No patient required a second operation. Midhepatic portal vein involvement may increase the risk of positive margins in patients with gastric carcinoid tumors. This degree of disease spread may preclude a distal gastrectomy. There was no significant difference in the recurrence rate for tumors that involved the portal vein and those that did not.Q:
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