摘要
腹主动脉瘤合并消化道恶性肿瘤较少见，其外科治疗策略目前仍存在争议，治疗难点主要在于手术方案的选择——是同期还是分期处理腹主动脉瘤与消化道恶性肿瘤，两种方案各有优点，但也有其不同的潜在风险。笔者结合相关研究文献回顾，探讨该类患者治疗策略。腹主动脉瘤腔内修复术逐渐成熟，成为治疗腹主动脉瘤首选，可在保证血供正常的前提下，同期切除消化道恶性肿瘤。对解剖条件合适患者，腹主动脉瘤腔内修复术联合腹腔镜消化道恶性肿瘤切除术的全微创治疗可能是最佳选择。
The incidence of concomitant abdominal aortic aneurysm （AAA） combined with gastrointestinal malig- nancy is rare, but it still represents an issue of controversy regarding the optimal treatment. It is unclear whether to treat the AAA and gastrointestinal malignancy simultaneously or in a staged manner as both options offer advantages but also carry some substantial risks. This study attempts a historical review of the surgical practice during the past decades by reviewing the existing literatures on this topic. In general, the most symptomatic lesion or the most life threatening condition should be treated firstly. Large aneurysm should usually be resected in preference to gastrointestinal malignancy unless the tumor is locally advanced, perforated or likely to result in intestinal obstruction. If both lesions are complicated there may be a case for simultaneous treatment. The evolution of vascular stents and the reported effi- cacy of endovascular aortic repair （EVAR） provide an alternative method for treating high risk patients. If the anatomical cri- teria are satisfied, EVAR combined with laparoscopic operation could become the optimal solution for the concomitant AAA and gastrointestinal malignancy patients, especially those who require minimally invasive treatment.
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2017年第11期1091-1093,共3页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金（81270378）
国家卫生和计划生育委员会临床学科重点项目（254003）
关键词
腹主动脉瘤
消化道恶性肿瘤
外科手术
腹主动脉腔内修复术
Abdominal aortic aneurysm
Gastroin-testinal malignancy
Surgical proce-dures, operative
Endovascular aorticrepair
