H. Kuwano et al., SUCCESSFUL SIMULTANEOUS RESECTION AND RECONSTRUCTION OF ABDOMINAL AORTIC-ANEURYSM AND ESOPHAGEAL CANCER, Journal of medicine, 26(1-2), 1995, pp. 76-86
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.