Surgical treatment of gastric cancer with coexistent abdominal aortic aneurysm. Personal experience and literature review

Background/aims: There are great controversies regarding the surgical management of abdominal aortic aneurysm (AAA) with coexistent gastrointestinal cancers. The aim of this study was to report our experience of AAA with concomitant gastric cancer and to compare our results with the literature. Methodology: From January 1988 to December 2002, six patients with simultaneous diagnosis of AAA and gastric cancer were operated on at the First Department of General Surgery, University of Verona, Italy. The study was completed with the review of the literature data collected by Medline search. Results: The surgical treatment of the cases observed at our Institution, 2 treated by a staged procedure, 2 by synchronous surgery and 2 in which the AAA remained untreated due to the evidence of metastatic disease at laparotomy, were described. Furthermore 47 cases, previously described in literature, 21 who underwent staged surgery, 23 with a synchronous procedure and 3 in which the treatment was limited to the tumor were analyzed. Conclusions: 1) Synchronous treatment of AAA and gastric cancer is feasible, 2) it can be done with an adequate extent of gastric resection and nodal dissection in the majority of cases, 3) it has a complications rate comparable to the staged procedure.