腹主动脉瘤合并消化器官恶性肿瘤的外科治疗

Surgical management for an abdominal aortic aneurysm complicated with malignancy of the digestive organs.

目的 探讨腹主动脉瘤合并消化器官恶性肿瘤的外科治疗方法。方法 回顾性分析 9例腹主动脉瘤合并消化器官恶性肿瘤病例的临床和手术资料。结果 腹主动脉瘤和消化器官恶性肿瘤同期手术 6例 ,其中 3例腹主动脉瘤行外包裹术 ;分期手术 1例 ,仅作恶性肿瘤根治 2例。同期手术 2例和仅作恶性肿瘤根治 2例仍生存。 2例死于术后并发症 ,3例死于心脏疾患和肿瘤晚期。无一例死于腹主动脉瘤破裂。结论 腹主动脉瘤与消化器官恶性肿瘤并存时 ,应优先处理有绝对急诊手术指征的病变。如均无症状时 ,应优先处理恶性肿瘤。在病人情况许可的情况下 ,应考虑同期手术治疗腹主动脉瘤 。

Objective To study surgical management for an abdominal aortic aneurysm(AAA) complicated with malignancy of the digestive organs.Methods The clinical data of 9 cases with AAA complicated with malignancy of the digestive organs were retrospectively analysed.Results A one-stage operation of AAA and the malignant tumor of the digestive organs was performed on 6 cases,of which 3 cases were given an aneurysmectomy and 3 cases with an aneurysm wrapping.A two-stage operation with resection of the malignancy first was performed on 1 case.The other 2 cases were only given the resection of the malignancies.Two cases with one-stage operation and 2 cases with only resection of malignancies are still alive.Two cases died of the postoperative complications,and 3 cases died of the heart disease and cancer deterioration.No case died of the rupture of AAA.Conclusion For concomitant AAA and the digestive cancer,the lesion that absolutely indicates urgent operation should be operated on first,and the malignant lesion should be resected first if both lesions seem asyptomatic.One-stage operation should be considered to perform on the patients in good condition,or else two-stage operation should be performed.