Surgical Strategy for the Treatment of Concomitant Abdominal Aortic Aneurysm and Gastrointestinal Malignancy.
10.4326/jjcvs.26.308
- VernacularTitle:腹部大動脈りゅうと腹部悪性腫ようが併存した症例に対する外科治療
- Author:
Michiya Bando
;
Hajime Hirose
;
Koji Matsumoto
;
Masaya Shibata
;
Matsuhisa Imaizumi
;
Yoshitaka Kumada
;
Hisato Takagi
;
Shinji Murakawa
;
Yoshio Mori
;
Shigeyuki Fuwa
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1997;26(5):308-312
- CountryJapan
- Language:Japanese
-
Abstract:
There are various problems associated with the surgical management of concomitant abdominal aortic aneurysm (AAA) and gastrointestinal malignancy. Our surgical strategy for the treatment of concomitant AAA and gastrointestinal malignant diseases, with the exception of colorectal diseases is basically a one-stage operation. This report reviews 6 cases involving concomitant AAA and gastrointestinal malignancy (colon cancer in 3 cases, gastric cancer in 2 and hepatoma in one). In 2 cases involving gastric cancer, we selected a one-stage operation for the coexistent AAA and gastrointestinal malignancy. The postoperative courses were uneventful. In a 69-yearold man with concomitant AAA, hepatoma and ischemic heart disease, a hepatectomy and coronary revascularization preceded AAA repair because the AAA diameter was too small. AAA repair was performed after 4 months when its diameter had been enlarged. In one of the 3 cases involving concomitant AAA and colon cancer, the malignancy was resected first and the patient died of recurrence 7 months after the operation and prior to the operation for AAA. In the second case of colon cancer, AAA repair preceded the resection of the malignancy. A right hemicolectomy was performed 53 days after the AAA operation. The third case had a one-stage operation for coexistent AAA and colon cancer. His postoperative course was uneventful. In this case, we took particular care to avoid graft infection. The 5 cases that underwent both operations have survived without major complications or evidence of recurrence during a follow-up period ranging from 2 months to 4 years.
