SURGICAL-MANAGEMENT FOR A MALIGNANCY OF THE DIGESTIVE ORGANS ACCOMPANIED WITH AN ABDOMINAL AORTIC-ANEURYSM

Surgical management of patients with simultaneous coexisting malignanc y of the digestive organs and an abdominal aortic aneurysm (AAA) remai ns controversial. In the five patients who underwent the aneurysmectom y first, no complications developed after an aneurysmectomy and a rese ction of malignancy could be performed within 4 weeks, whereas postope rative complications after the resection of malignancy developed in tw o of them. Two patients underwent a one-stage operation, in which one was unable to tolerate the two procedures, and no postoperative compli cations were seen; however, one patient with cardiac dysfunction who f irst underwent an aneurysmectomy died 3 months after operation due to cardiac and renal failure. These results indicate that the aneurysmect omy first is preferred, when such patients do not have absolute indica tions of malignancy or AAA; however, a one-stage operation should be c hosen when the patients show a disturbance of key organs.