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Concurrent abdominal aortic aneurysm and urologic neoplasm: an argument for simultaneous intervention.

Abstract：

:This report describes the surgical management of 24 patients with concurrent abdominal aortic aneurysm (AAA) and urinary tract neoplasm. The patient population consisted of 22 men and two women whose average age was 65.5 years. AAA sizes ranged from 3.1 to 9.0 cm (mean 5.2 cm) in diameter. Urinary tract neoplasms included transitional cell carcinoma (TCC) of the bladder (n = 19), adenocarcinoma of the prostate (n = 3), and TCC of the renal pelvis (n = 2). Urologic procedures included radical prostatectomy, radical nephroureterectomy, and radical cystoprostatectomy with continent or ileal loop urinary diversion. The AAA was resected at the time of the urologic procedure in 12 patients (group I) or prior to the urologic procedure in five patients (group II) and was left in situ in seven patients (group III: AAA diameter 3.1 to 5.5 cm). All patients but one in group I recovered without complications. One patient developed an infection postoperatively as a result of fluid collection anterior to the aortic vascular graft; the fluid was successfully drained and the patient subsequently recovered uneventfully. All patients in group II had a marked retroperitoneal desmoplastic reaction at the time of the urologic procedure as a result of prior aneurysmectomy, which complicated the ureteral dissection. One patient later required an ileal ureteral reconstruction for obliterative fibrosis of the ureter. At a mean follow-up of 34 months, no infectious or mechanical complications of the vascular prosthesis occurred in group I or II. Eight patients in group I and two in group II are alive. Three have died of metastatic disease and two of myocardial infarction. Of the seven patients in group III, four subsequently required AAA resection for an increase in AAA size and three have died.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Ginsberg DA,Modrall JG,Esrig D,Baek S,Yellin AE,Lieskovsky G,Skinner DG,Weaver FA

doi

10.1007/BF02143854

subject

Has Abstract

pub_date

1995-09-01 00:00:00

pages

428-33

issue

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(06)62072-4

journal_volume

pub_type

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Concurrent abdominal aortic aneurysm and urologic neoplasm: an argument for simultaneous intervention.