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Ning JJ, Yao C, Chang GQ, Wang SM. Surgical Treatment of Superior Thyroid Artery Aneurysm with Concomitant Thyroid Cancer. Chin Med J (Engl) 2018; 130:2885-2886. [PMID: 29176150 PMCID: PMC5717872 DOI: 10.4103/0366-6999.219145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jun-Jie Ning
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Chen Yao
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Guang-Qi Chang
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Shen-Ming Wang
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
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2
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Meta-analysis of Outcomes Following Aneurysm Repair in Patients with Synchronous Intra-abdominal Malignancy. Eur J Vasc Endovasc Surg 2016; 52:747-756. [PMID: 27592036 DOI: 10.1016/j.ejvs.2016.07.084] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 07/20/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The management of concomitant intra-abdominal malignancy (IAM) and abdominal aortic aneurysm (AAA) remains a challenge, even though malignancy is common in an elderly population. By means of systematic review and meta-analysis, the aim was to investigate outcomes in patients undergoing open (OAR) or endovascular AAA repair (EVAR) that have a concomitant malignancy. METHODS A systematic literature review was performed (Medline and EMBASE databases) to identify all series reporting outcomes of AAA repair (OAR or EVAR) in patients with concomitant IAM. Meta-analysis was applied to assess mortality and major morbidity at 30 days and long term. RESULTS The literature review identified 36 series (543 patients) and the majority (18 series) reported on patients with colorectal malignancy and AAA. Mean weighted mortality for OAR at 30 days was 11% (95% CI: 6.6% to 17.9%); none of the EVAR patients died peri-operatively. The weighted 30-day major complication rate for EVAR was 20.4% (10.0-37.4%) and for OAR it was 15.4% (7.0-30.8%). Most patients had their AAA and malignancy treated non-simultaneously (56.6%, 95% CI, 42.1-70.1%). In the EVAR cohort, three patients (4.6%) died at last follow-up (range 24-64 months). In the OAR cohort 23 (10.6%) had died at last follow up (range from 4 to 73 months). CONCLUSION In this meta-analysis, OAR was associated with significant peri-operative mortality in patients with an IAM. EVAR should be the first-line modality of AAA repair. The majority of patients were not treated simultaneously for the two pathologies, but further investigation is necessary to define the optimal timing for each procedure and malignancy.
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Mohandas S, Malik HT, Syed I. Concomitant abdominal aortic aneurysm and gastrointestinal malignancy: evolution of treatment paradigm in the endovascular era - review article. Int J Surg 2012; 11:112-5. [PMID: 23266417 DOI: 10.1016/j.ijsu.2012.11.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 11/16/2012] [Accepted: 11/30/2012] [Indexed: 02/07/2023]
Abstract
The incidence of concomitant abdominal aortic aneurysm and gastrointestinal malignancy is rare. Current treatment strategies in patients with both lesions remain controversial. It is unclear whether to treat the AAA and gastrointestinal malignancy simultaneously or in a staged manner. In patients with concomitant AAA and gastrointestinal malignancy surgical orthodoxy dictates that the most symptomatic lesion or the most life threatening condition should be treated first, however there is a therapeutic dilemma when neither or both of the lesions are symptomatic .In this review we explore (a) Priority of treatment in patients with concomitant abdominal aortic aneurysm and gastrointestinal malignancy (b) The role of EVAR in the management of abdominal aortic aneurysm and concomitant gastrointestinal malignancy.
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Affiliation(s)
- Shailesh Mohandas
- Queens University Hospital, Rom Valley Way, Romford, Essex RM7 0AG, UK.
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Matsuno Y, Ishida N, Fukumoto Y, Shimabukuro K, Takemura H. Simultaneous endovascular aneurysm repair and distal gastrectomy in a patient with concomitant abdominal aortic aneurysm and advanced gastric cancer. Ann Vasc Dis 2012; 5:69-72. [PMID: 23555489 DOI: 10.3400/avd.cr.11.00066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 11/02/2011] [Indexed: 11/13/2022] Open
Abstract
The optimal surgical management of patients with concomitant abdominal aortic aneurysm (AAA) and gastrointestinal malignancy remains controversial. A 79 year-old man who presented with hematemesis was found to have advanced gastric cancer concomitant with infrarenal AAA. The patient underwent simultaneous endovascular aneurysm repair (EVAR) and distal gastrectomy. The postoperative course was uneventful. The present case illustrates the clinical utility of EVAR for the high-risk patient with concomitant AAA and gastrointestinal malignancy.
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Affiliation(s)
- Yukihiro Matsuno
- Department of Advanced Surgery, Division of Organ Pathobiology, Gifu University School of Medicine, Gifu, Gifu, Japan
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5
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Gastrointestinal malignancies and cardiovascular diseases—Non-negligible comorbidity in an era of multi-antithrombotic drug use. J Cardiol 2011; 58:199-207. [DOI: 10.1016/j.jjcc.2011.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 07/19/2011] [Accepted: 08/18/2011] [Indexed: 12/23/2022]
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Komori K, Okazaki J, Kawasaki K, Kuma S, Eguchi D, Mawatari K, Itoh H, Onohara T, Sugimachi K. Comparison of retroperitoneal and transperitoneal approach for reconstruction of abdominal aortic aneurysm in patients with previous laparotomy. Int J Angiol 2011. [DOI: 10.1007/bf01616218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Jibawi A, Ahmed I, El-Sakka K, Yusuf SW. Management of concomitant cancer and abdominal aortic aneurysm. Cardiol Res Pract 2011; 2011:516146. [PMID: 21559270 PMCID: PMC3087962 DOI: 10.4061/2011/516146] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 01/04/2011] [Accepted: 02/23/2011] [Indexed: 12/31/2022] Open
Abstract
Background. The coexistence of neoplasm and abdominal aortic aneurysm (AAA) presents a real management challenge. This paper reviews the literature on the prevalence, diagnosis, and management dilemmas of concurrent visceral malignancy and abdominal aortic aneurysm. Method. The MEDLINE and HIGHWIRE databases (1966-present) were searched. Papers detailing relevant data were assessed for quality and validity. All case series, review articles, and references of such articles were searched for additional relevant papers. Results. Current challenges in decision making, the effect of major body-cavity surgery on an untreated aneurysm, the effects of major vascular surgery on the treatment of malignancy, the use of EVAR (endovascular aortic aneurysm repair) as a fairly low-risk procedure and its role in the management of malignancy, and the effect of other challenging issues such as the use of adjuvant therapy, and patients informed decision-making were reviewed and discussed. Conclusion. In synchronous malignancy and abdominal aortic aneurysm, the most life-threatening lesion should be addressed first. Endovascular aneurysm repair where possible, followed by malignancy resection, is becoming the preferred initial treatment choice in most centres.
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Affiliation(s)
- Abdullah Jibawi
- The Vascular Unit, Brighton and Sussex University Hospital, Brighton BN25BE, UK
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Concomitant abdominal aortic aneurysm and rectal cancer: a treatment dilemma. Tech Coloproctol 2009; 13:327-8. [PMID: 19813076 DOI: 10.1007/s10151-009-0541-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Somasekar K, Morris-Stiff G, Foster ME, Lewis MH. Prioritizing treatment in cases of concurrent abdominal aortic aneurysm. HOSPITAL MEDICINE (LONDON, ENGLAND : 1998) 2002; 63:566-8. [PMID: 12357869 DOI: 10.12968/hosp.2002.63.9.1959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Patients with concomitant abdominal aortic aneurysm (AAA) and intra-abdominal malignancy present a clinical dilemma because of the difficulty in deciding which pathology to address first. As this scenario is not commonly encountered, clear guidelines are not available to help in the decision-making process. Surgery for malignancy has been said to increase the risk of postoperative aneurysm rupture, but simultaneous cancer surgery and primary repair of the aneurysm may carry the risk of prosthetic graft infection. This paper describes a further complication that may arise in the setting of concomitant intra-abdominal malignancy carcinoma and AAA, namely peripheral embolism.
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Affiliation(s)
- K Somasekar
- Royal Glamorgan Hospital, Llantrisant, Rhondda, Cynon Taff CF72 8XR
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10
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Kaltenbacher A, Lugmayr H, Hietler F. Metachrone Gastrektomie bei Magenkarzinom nach transfemoralem Aortenstenting - Fallbericht aus einem Standardkrankenhaus. Eur Surg 2001. [DOI: 10.1046/j.1563-2563.2001.01065.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Oshodi TO, Abraham JS, Brigg JK, Kelly JF. Management of co-existing intra-abdominal disease in aortic surgery. Eur J Vasc Endovasc Surg 2000; 19:43-6. [PMID: 10706833 DOI: 10.1053/ejvs.1999.0925] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES the treatment of abdominal aortic aneurysms more than 5 cm in diameter is well accepted, but controversy surrounds the management of concomitant serious intra-abdominal lesions diagnosed in the perioperative period. This study was undertaken to demonstrate that synchronous surgery is feasible and safe in this group of patients. DESIGN in 1978 a decision was made to undertake combined operations on all patients with an aortic aneurysm of 5 cm or more in diameter and a significant non-vascular intra-abdominal lesion requiring surgery. METHODS the case records of 676 patients who had aortic grafting for aneurysmal disease or the urgent management of occlusive disease between 1978 and 1998 were analysed retrospectively. SETTING district general hospital. RESULTS fifty-six (8%) patients had co-existing intra-abdominal disease treated at the time of aortic graft surgery. There were three (5%) hospital deaths and seven patients required early reoperation. One patient developed a subphrenic abscess and there were three superficial wound infections. There has been no clinical evidence of aortic graft infection in this series. CONCLUSION this single centre experience with synchronous surgery demonstrates that it is safe and does not appear to predispose to an increased risk of graft infection.
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Affiliation(s)
- T O Oshodi
- Department of Surgery, Royal Lancaster Infirmary, Ashton Road, Lancaster, LA1 4RP, UK
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Nakata Y, Kimura K, Tomioka N, Kawasaki S, Takagaki Y. Successful simultaneous operation of concomitant early gastric cancer, transverse colon cancer, and a common iliac artery aneurysm. Surg Today 1999; 29:782-4. [PMID: 10483757 DOI: 10.1007/bf02482327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In an 83-year-old Japanese man, concomitant bleeding colon cancer, early gastric cancer, and an expanding right common iliac artery aneurysm were evident. The patient underwent an artificial graft implantation, partial gastrectomy, and transverse colectomy, simultaneously. To protect against graft infection, the aneurysm was resected first, and then the retroperitoneum was tightly closed to isolate the graft from the peritoneal cavity. The postoperative course was uneventful, except for symptoms of temporary delirium. Recently, simultaneous surgery for concomitant abdominal aortic aneurysms and early gastric cancer has been commonly performed in Japan because the contamination of the peritoneal cavity during a gastrectomy is thought to be less severe than that during lower abdominal surgery. However, the positive rate for bacterial culture in colorectal resections is virtually the same as that in gastrectomies. Moreover, the incidence of graft infection is substantially lower than the positive rate for bacterial culture in surgery for aneurysms. Some surgeons object to a simultaneous resection due to fear of graft infection, but even the presence of infectious organisms does not always result in graft infection. The present case illustrates the benefits of a simultaneous operation for both an aneurysm and gastrointestinal malignancy.
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Affiliation(s)
- Y Nakata
- Department of Surgery, Kita Ishikai Hospital, Tokunomori, Oozu, Ehime, Japan
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Kurata S, Nawata K, Nawata S, Hongo H, Suto R, Nagashima H, Kuroda Y, Nakayasu K, Shirasawa B, Esato K. Surgery for abdominal aortic aneurysms associated with malignancy. Surg Today 1998; 28:895-9. [PMID: 9744397 DOI: 10.1007/s005950050249] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Of 148 patients treated for abdominal aortic aneurysms (AAA), 33 (22%) also had cancer. According to the classification of Szilagyi, there were 13 patients in group I, 19 in group II, and 1 in group IV. In group I, the mean interval between the cancer and AAA operations was 7 years (range 1-14 years). Aneurysmectomy was performed in 9 patients, wrapping in 2, and no operation in 2. In group II, a two-stage operation was performed in 8 patients, a single-stage operation in 4, only surgery for cancer in 4, and no operation in 3. Of 4 patients undergoing single-stage operations, 3 had colorectal cancer, and there were no postoperative complications such as graft infection or anastomotic breakdown. In group I, 6 of 13 patients died, but there were no cancer deaths. In group II, 9 of 19 patients died, 6 from progressive cancer. The group IV patient also died of cancer. These results suggest that if a patient can tolerate surgery for both diseases, a single-stage operation is preferable.
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Affiliation(s)
- S Kurata
- Department of Surgery, Yamaguchi Central Hospital, Hofu, Japan
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Egeberg T, Haug ES, Thoresen JE, Myhre HO. Concomitant intra-abdominal disease in aortic surgery. Eur J Vasc Endovasc Surg 1997; 14 Suppl A:18-23. [PMID: 9467608 DOI: 10.1016/s1078-5884(97)80147-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- T Egeberg
- Department of Surgery, University Hospital of Trondheim, Norway
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Yasuda H, Hiraishi T, Katoh O, Kobayashi T. The coexistence of abdominal aortic aneurysm and advanced gastric cancer associated with recurrent angina after coronary artery bypass grafting. JAPANESE CIRCULATION JOURNAL 1997; 61:947-950. [PMID: 9391863 DOI: 10.1253/jcj.61.947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A 76-year-old man with abdominal aortic aneurysm (AAA) and concomitant gastric cancer, who had undergone coronary artery bypass grafting (CABG), presented with recurrent exertional angina. Both lesions, the AAA and advanced gastric cancer, exhibited an absolute indication for urgent surgery. Coronary revascularization with percutaneous transluminal coronary angioplasty (PTCA) was carried out successfully before abdominal surgery. A one-stage abdominal operation was performed safely. The need for coronary revascularization complicates the treatment strategy for these patients with associated coronary artery disease. PTCA is the best option, especially if the patient presents with recurrent angina after prior CABG.
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Affiliation(s)
- H Yasuda
- Department of Cardiovascular Surgery, Osaka Medical Center for Cancer and Cardiovascular Disease, Japan
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Galt SW, McCarthy WJ, Pearce WH, Carter MF, Dalton DP, Garnett JE, Durham JR, Yao JS. Simultaneous abdominal aortic aneurysm repair and nephrectomy for neoplasm. Am J Surg 1995; 170:227-30. [PMID: 7631937 DOI: 10.1016/s0002-9610(99)80292-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Abdominal aortic aneurysm and renal neoplasm are occasionally discovered concurrently. Simultaneous operative therapy may be an effective alternate management strategy to a staged procedure. PATIENTS AND METHODS The medical records of 10 consecutive patients undergoing abdominal aortic aneurysm repair and nephrectomy for renal neoplasm were reviewed. Data collected included mode of presentation, preoperative evaluation, renal pathology, and in-hospital morbidity and mortality. Long-term follow-up was obtained through office records and telephone contact. RESULTS In 7 patients, the renal mass was identified during evaluation of abdominal aortic aneurysm. The aneurysm was identified during evaluation of hematuria in 2 patients. One patient was discovered to have both conditions simultaneously. All patients underwent successful aneurysm repair and nephrectomy. Pathology revealed 6 renal cell carcinomas, 2 complex cysts, 1 hemangiopericytoma, and 1 oncocytoma. Four patients have died in the follow-up period: 1 of metastatic cancer and 3 of unrelated causes. There have been no cases of graft infection. CONCLUSION Simultaneous abdominal aortic aneurysm repair and nephrectomy for neoplasm is an appropriate management strategy for selected patients.
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Affiliation(s)
- S W Galt
- Division of Vascular Surgery, Northwestern University Medical School, Chicago, Illinois 60611, USA
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