Bruno Amato1, Giovanni Esposito2, Raffaele Serra3, Rita Compagna4, Gabriele Vigliotti5, Tommaso Bianco6, Guido Massa7, Maurizio Amato8, Salvatore Massa9, Giovanni Aprea10. 1. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131 Napoli, Italy. Electronic address: bruno.amato@unina.it. 2. Department of Advanced Biomedical Sciences, Federico II University, Via Pansini 5, 80131 Naples, Italy. Electronic address: espogiov@unina.it. 3. Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, Headquarters - University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; Department of Medical and Surgical Sciences, University of Catanzaro, Italy. Electronic address: rserra@unicz.it. 4. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131 Napoli, Italy; Department of Advanced Biomedical Sciences, Federico II University, Via Pansini 5, 80131 Naples, Italy; Interuniversity Center of Phlebolymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, Headquarters - University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy. Electronic address: ritacompagna@libero.it. 5. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131 Napoli, Italy. Electronic address: federer2987@hotmail.it. 6. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131 Napoli, Italy. Electronic address: tommasobianco85@gmail.com. 7. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131 Napoli, Italy. Electronic address: guido.massa@libero.it. 8. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131 Napoli, Italy. Electronic address: maurizioamato@gmail.com. 9. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131 Napoli, Italy. Electronic address: smassa@unina.it. 10. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131 Napoli, Italy. Electronic address: aprea@unina.it.
Abstract
BACKGROUND: Endovascular aneurysm repair (EVAR) is still now a controversial technique, which remains the subject of a number of prospective randomised trials. Although questions remain regarding its long-term durability, objective evidence exists which demonstrates its reduced physiological impact compared with conventional open repair, especially for older population and for the concomitant treatment of aortic abdominal aneurysm (AAA) and abdominal neoplas, such as colo-rectal cancer (CRC). In these patients it may reduce the high perioperative mortality. PATIENTS AND METHODS: Abdominal aortic aneurysm and colo-rectal neoplasm are occasionally discovered concurrently. Simultaneous operative treatment may be in these cases an effective management strategy, alternative to a staged procedure. The medical record of three consecutive patients undergoing mini-invasive colectomy for cancer and abdominal aortic aneurysm repair were reviewed. Data collected included mode of presentation, preoperative evaluation, colo-rectal pathology and in-hospital morbidity and mortality. Long term follow-up was obtained through office records and telephone contact. RESULTS: In one patient a asymptomatic colo-rectal mass was identified in the course of CT-scan evaluation for AAA; in the other two patients AAA was discovered during CT-scan oncological evaluation for symptomatic CRC. All patients underwent successfully concomitant repair of AAA and CRC by means of EVAR procedure and mini-invasive colo-rectal resection. Pathology revealed adenocarcinomas in all three cases. Perioperative follow-up revealed minor postoperative complications. Two years follow-up showed no cases of graft infection, and no interference of vascular procedure on oncological course of the colo-rectal malignancies.
BACKGROUND:Endovascular aneurysm repair (EVAR) is still now a controversial technique, which remains the subject of a number of prospective randomised trials. Although questions remain regarding its long-term durability, objective evidence exists which demonstrates its reduced physiological impact compared with conventional open repair, especially for older population and for the concomitant treatment of aortic abdominal aneurysm (AAA) and abdominal neoplas, such as colo-rectal cancer (CRC). In these patients it may reduce the high perioperative mortality. PATIENTS AND METHODS: Abdominal aortic aneurysm and colo-rectal neoplasm are occasionally discovered concurrently. Simultaneous operative treatment may be in these cases an effective management strategy, alternative to a staged procedure. The medical record of three consecutive patients undergoing mini-invasive colectomy for cancer and abdominal aortic aneurysm repair were reviewed. Data collected included mode of presentation, preoperative evaluation, colo-rectal pathology and in-hospital morbidity and mortality. Long term follow-up was obtained through office records and telephone contact. RESULTS: In one patient a asymptomatic colo-rectal mass was identified in the course of CT-scan evaluation for AAA; in the other two patients AAA was discovered during CT-scan oncological evaluation for symptomatic CRC. All patients underwent successfully concomitant repair of AAA and CRC by means of EVAR procedure and mini-invasive colo-rectal resection. Pathology revealed adenocarcinomas in all three cases. Perioperative follow-up revealed minor postoperative complications. Two years follow-up showed no cases of graft infection, and no interference of vascular procedure on oncological course of the colo-rectal malignancies.
Authors: Bruno Amato; Renato Patrone; Gennaro Quarto; Rita Compagna; Roberto Cirocchi; Georgi Popivanov; Vincenza Granata; Andrea Belli; Francesco Izzo Journal: Open Med (Wars) Date: 2020-09-11