同时处理腹主动脉瘤和腹内、腹膜后恶性肿瘤。
Management of Concomitant Abdominal Aortic Aneurysm and Intra-abdominal, Retroperitoneal Malignancy.
机构信息
Department of Surgery, School of Medicine in Pilsen, Charles University in Prague, Prague, Prague, Czech Republic;
Department of Surgery, School of Medicine in Pilsen, Charles University in Prague, Prague, Prague, Czech Republic.
出版信息
In Vivo. 2021 Jan-Feb;35(1):517-523. doi: 10.21873/invivo.12286.
BACKGROUND/AIM: As the population ages, there are increasing findings of coincidental diseases such as abdominal aortic aneurysm (AAA) and intra-abdominal, retroperitoneal malignancy. The aim of this study was to propose an optimal treatment procedure for these patients.
PATIENTS AND METHODS
Over a twenty-year-period, surgery was performed on a total of 1,098 patients with AAA and 32 (2.9%) patients with AAA and intra-abdominal, retroperitoneal malignancy: 18 renal, 6 colorectal carcinomas, 3 carcinomas of the small intestine, 3 primary liver tumours, 1 stomach carcinoma and 1 teratoma. The median age of patients was 72.5 years, there were 20 men (62.5%) and 12 women (37.5%). A one-stage procedure was performed on 19 patients (59.4%), and a two-stage procedure on 13 (40.6%) patients.
RESULTS
The average time of hospitalization was 12.4±6.9 days (median=11.0 days) for one-stage procedure, for a two-stage procedure 21.3±9.3 days (median=20.0 days), p=0.0045. Seven patients (21.9%) died within 30 days after the operation. All the deaths were in the group of one-stage procedures (p=0.0252). The 1-, 3- and 5-year overall survival for patients following one-stage and twostage procedures was 61.0/56.3/51.5% and 89.0/79.9/53.0% respectively (p=0.1199).
CONCLUSION
Symptomatic disease must be resolved first. Two-stage procedures are the method of choice and offer better short-term results compared to one-stage procedures.
背景/目的：随着人口老龄化，越来越多的患者同时患有腹部主动脉瘤（AAA）和腹腔内、腹膜后恶性肿瘤等合并症。本研究旨在为这些患者提出一种最佳的治疗方案。
患者和方法
在二十年期间，共对 1098 例 AAA 患者和 32 例（2.9%）AAA 合并腹腔内、腹膜后恶性肿瘤的患者进行了手术：18 例为肾癌，6 例为结直肠癌，3 例为小肠癌，3 例为原发性肝癌，1 例为胃癌，1 例为畸胎瘤。患者的中位年龄为 72.5 岁，其中男性 20 例（62.5%），女性 12 例（37.5%）。19 例（59.4%）患者采用一期手术，13 例（40.6%）患者采用二期手术。
结果
一期手术的平均住院时间为 12.4±6.9 天（中位数=11.0 天），二期手术的平均住院时间为 21.3±9.3 天（中位数=20.0 天），p=0.0045。术后 30 天内有 7 例患者（21.9%）死亡。所有死亡均发生在一期手术组（p=0.0252）。一期和二期手术后患者的 1 年、3 年和 5 年总生存率分别为 61.0/56.3/51.5%和 89.0/79.9/53.0%（p=0.1199）。
结论
必须先解决有症状的疾病。与一期手术相比，二期手术是首选方法，可获得更好的短期结果。
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