Management of synchronous infrarenal aortic disease and large bowel cancer: a North-east of Scotland experience

Objectives: to review our experience of combined aortic and colonic surgery . Design: retrospective review. Methods: synchronous aortic and colorectal procedures were identified from prospective computerised audit and archival vascular records. Clinical para meters were used as surrogates for measuring clinical outcome. Results: six patients (F:M=2:1), median age 75.6 years (range 70-80 years) were identified with infrarenal aortic pathology (5 aneurysms, median AP di ameter 6 cm, 1 occluded aortoiliac segment) and colonic carcinoma. All carc inomas were Dukes stage B and moderately well differentiated. Synchronous a ortic and colonic resections were performed in five cases, bypass for aorto iliac occlusion was deferred in preference to colonic resection in one case . Operating time ranged between 3-6.5 hours (median 4 h), transfusion requi rements 2-5 units (median 3 units). One anastomotic dehiscence was reported . With follow-up between 6 months to 6 years all patients remain alive; no patient has re-presented with graft sepsis ol symptomatic tumour recurrence . Conclusion: synchronous resections of aortic and colonic lesion may be a tr eatment option in selected cases.