SUCCESSFUL SIMULTANEOUS RESECTION AND RECONSTRUCTION OF ABDOMINAL AORTIC-ANEURYSM AND ESOPHAGEAL CANCER

A simultaneous resection and reconstruction of abdominal aortic aneury sm (AAA) and esophageal cancer was performed on an eighty-year-old Jap anese man. In spite of his advanced age, preoperative assessments reve aled that the general functions of the patient were quite satisfactory . An esophagram, endoscopy and CT scan all demonstrated the esophageal cancer to be in a relatively early stage without any lymph node metas tasis, while the CT scan demonstrated an infrarenal type of fusiform a bdominal aortic aneurysm with a maximam transverse diameter of 7.0 cm. A simultaneous resection and reconstruction of both the AAA and esoph ageal cancer was performed on August 8, 1991. First, the operation for AAA was done through a retroperitoneal approach, and next, a resectio n and reconstruction of the esophageal cancer was performed with a rig ht thoracotomy and laparotomy using the gastric tube as an esophageal substitute. The postoperative course was uneventful except for a tempo rary purulent discharge through the mediastinal drain. The patient was discharged on the 56th postoperative day. Therefore, when the general conditions are considered to be tolerable for operation, such a simul taneous operation may be indicated even inpatients of advanced age by utilizing isolated approaches and taking great care.