Associated intra-abdominal lesions encountered during resection of aortic aneurysms surgical considerations

Abstract

Resection of the lesion and aortic substitution by a vascular prosthesis has replaced all other methods of treatment of abdominal aortic aneurysm. An analysis of 931 patients undergoing this operation revealed that more than two thirds of these individuals had one or more concomitant operations performed either for therapeutic or prophylactic reasons. Incidental appendectomy was the most commonly performed associated operation although lumbar sympathectomy, cholecystectomy, gastric resection, various herniorrhaphies and subtotal colectomy were also relatively common. In our cases the performance of two operative procedures concurrently did not add to the morbidity or mortality rate of the aneurysmectomy. Division of the inferior mesenteric artery was employed in practically all cases as a necessary technical step in resection of the aneurysm of the abdominal aorta. Collateral circulation of the left colon and rectum was adequate to sustain viability if precautions were taken to protect these collateral circuits.