Habets Jesse, Buth Jaap, Cuypers Philippe W M, Nienhuijs Simon W, de Hingh Ignace H J T
Department of Surgery, Cahtarina Hospital Eindhoven, Eindohoven, the Netherlands.
Vascular. 2010 Jan-Feb;18(1):14-9. doi: 10.2310/6670.2009.00058.
During diagnostic workup for urologic malignancies, an abdominal aortic aneurysm (AAA) is identified in a proportion of patients. In the era of open AAA repair, these patients presented a surgical dilemma with regard to the sequence of the operations: cancer treatment first or AAA repair first? Previous assessments have concluded that irrespective of the followed strategy, the early and mediumterm mortality from the two operative procedures in this patient category was significant. With the introduction of endovascular aneurysm repair (EVAR), the mortality and morbidity associated with the treatment of both pathologic conditions may be more favorable than with open aneurysm repair. The objective of this study was to assess, in an institutional series of patients receiving EVAR, the early and long-term survival and complication rates in patients with urologic malignancies. In a series of 385 patients receiving EVAR, 14 had a concomitant urologic malignancy: renal cell carcinoma (5 patients), prostate carcinoma (6 patients), and carcinoma of the bladder (3 patients). The first-month mortality was nil. Long-term survival was 80%, 83%, and 67% for the three tumor types, respectively. EVAR offers improved treatment in patients with concomitant AAA and urologic malignancy and should be considered the first choice for these patients.
在对泌尿系统恶性肿瘤进行诊断性检查时，一部分患者被发现患有腹主动脉瘤（AAA）。在开放手术修复AAA的时代，这些患者在手术顺序方面面临两难境地：先进行癌症治疗还是先进行AAA修复？先前的评估得出结论，无论采取何种策略，这类患者接受这两种手术的早期和中期死亡率都很高。随着血管内动脉瘤修复术（EVAR）的引入，与治疗这两种病理状况相关的死亡率和发病率可能比开放动脉瘤修复术更有利。本研究的目的是在一组接受EVAR的患者中评估患有泌尿系统恶性肿瘤患者的早期和长期生存率及并发症发生率。在一组385例接受EVAR的患者中，有14例同时患有泌尿系统恶性肿瘤：肾细胞癌（5例）、前列腺癌（6例）和膀胱癌（3例）。第一个月的死亡率为零。三种肿瘤类型的长期生存率分别为80%、83%和67%。EVAR为同时患有AAA和泌尿系统恶性肿瘤的患者提供了更好的治疗方法，应被视为这些患者的首选治疗方式。
