PSA. 140 / 90mmHg. TG 457mg / dl. Gleason T2a. Fig. 1 MRA. Fig Tel:
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1 PSA PSA PSA 18.2ng / ml4.0ng / ml Tel: CT 167cm 71kg 70 / 140 / 90mmHg TG 457mg / dl Gleason T2a CT 38mm30mm Fig. 1 MRA Fig
2 14 1 Fig. 1 Preoperative abdominal CT. Bilateral iliac artery aneurysms were seen. The maximal diameters were 38 mm in right, 30 mm in left. Calcification of aortic wall was relatively mild. 35mm35mm30mm K 16 8mm Y Y 8mm (Fig. 3) Fig. 2 Preoperative aortic MRA (magnetic resonance angiography). Bilateral common iliac artery aneurysms were seen (white arrows). Bilateral internal iliac arteries also showed aneurysmal changes (black arrows). 2,200ml 310ml 3,000ml 1,100ml 4 10 Adenocarcinoma Gleason score = 7 T2 N0 M0 Stage II 2 CPK IU / L 15 IA-DSA 18
3 AA 30mm RCIA 38mm REIA 10mm RIIA 14mm LIIA 11mm IMA LCIA 30mm LEIA 10mm Inter Gard 16 8mm Fig. 3 a b Operative findings. (a) Pre-graft replacement. (b) Post-graft replacement. AA, abdominal aorta; IMA, inferior mesenteric artery; RCIA, right common iliac artery; LCIA, left common iliac artery; REIA, right external iliac artery; LEIA, left external iliac artery; RIIA, right internal iliac artery; LIIA, left internal iliac artery. Fig poor risk 3 Matsumoto 4 14 Nakata Fig. 4 Postoperative IA-DSA. Graft anastomosed to the right internal iliac artery was occluded (white arrows). Komori 6 Swanson
4 mm 3 1 PTFE polytetrafluoroethylene Matsumoto, K., Nakamaru, M., Obara, H., et al.: Surgical strategy for abdominal aortic aneurysm with concurrent symptomatic malignancy. World J. Surg., 23: , Nakata, Y., Kimura, K., Tomioka, K., et al.: Successful simultaneous operation of concomitant early gastric cancer, transverse colon cancer, and a common iliac artery aneurysm. Surg. Today, 29: , Komori, K., Okadome, K., Itoh, H., et al.: Management of concomitant abdominal aortic aneurysm and gastrointestinal malignancy. Am. J. Surg., 166: , Swanson, R. J., Littooy, F. N., Hunt, T. K., et al.: Laparotomy as a precipitating factor in the rupture of intraabdominal aneurysms. Arch. Surg., 115: , UCSF Lierz, M. F., Davis, B. E., Noble, M. J., et al.: Management of abdominal aortic aneurysm and invasive transitional cell carcinoma of bladder. J. Urol., 149: Komori, K., Okadome, K., Funahashi, S., et al.: Surgical strategy of concomitant abdominal aortic aneurysm and gastric cancer. J. Vasc. Surg., 19: Ginsberg, D. A., Modrall, J. G., Esrig, D., et al.: Concurrent abdominal aortic aneurysm and urologic neoplasm: An argument for simultaneous intervention. Ann. Vasc. Surg., 9: Schmitt, D. D., Bandyk, D. F., Pequet, A. J., et al.: Bacterial adherence to vascular prostheses: a determinant of graft infectivity. J. Vasc. Surg., 3:
5 Simultaneous Operation of Concurrent Bilateral Common Iliac Artery Aneurysms and Prostate Cancer Takayo Maekawa 1, Tatsuro Asada 1, Takashi Azami 1, Taro Hayashi 1, Hiroyuki Tanaka 2, and Osamu Matsumoto 2 1 Department of Cardiovascular Surgery, Miki City Hospital, 2 Department of Urology, Miki City Hospital Key words: Bilateral common iliac artery aneurysms, Prostate cancer, Simultaneous operation We performed a simultaneous operation for concurrent bilateral common iliac artery aneurysms and prostate cancer. A 71-year-old man was examined because of high level of serous prostate specific antigen and the coexistence of bilateral common iliac artery aneurysms and prostate cancer was recognized. We decided to perform a simultaneous operation because his general condition was well enough to tolerate a simultaneous operation and that was what he wanted. Graft replacement with a Y graft was performed after radical retropubic prostatectomy without any severe complications. This is the first report in Japan of the simultaneous operation for iliac artery aneurysms and prostate cancer. This experience suggests that this simultaneous operation is feasible and effective, since it is easier to maintain the sterility of the operative field for urologic neoplasm as compared with that of the operation for gastrointestinal malignancy. Jpn. J. Vasc. Surg., 14: 17-21,
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