Laparoscopic Management of Concomitant Sigmoid Colon Cancer and Type 2 Endoleak Following Endovascular Aneurysm Repair. (July 2022)

• Record Type: Journal Article
• Authors: Bakopoulos, Anargyros; Koliakos, Nikolaos; Papaconstantinou, Dimitrios; Bistarakis, Dimitrios; Zymvragoudakis, Vassilios; Schizas, Dimitrios; Pikoulis, Emmanouil; Lazaris, Andreas M.
• Is Part Of: Vascular & endovascular surgery. Volume 56:Number 5(2022)
• Page Start: 505
• Page End: 508
• Publication Date: 2022-07
• Subjects: aortic aneurysm -- endovascular repair -- endoleak -- colon cancer -- laparoscopic colectomy; Blood-vessels -- Surgery -- Periodicals; Blood-vessels -- Endoscopic surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioplasty -- Periodicals; Surgical Procedures, Minimally Invasive -- Periodicals; Vascular Diseases -- surgery -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; 617.41
• DOI: 10.1177/15385744221083087
• Languages: English
• ISSNs: 1538-5744

Abstract

The co-occurrence of abdominal aortic aneurysm (AAA) and colorectal malignancy creates a significant surgical dilemma over which entity should be addressed first. A 73-year-old male was referred to our hospital due to a painful pulsatile abdominal mass. Computed tomographic angiography revealed an infrarenal aortic aneurysm measuring 5.8 cm in diameter and incidentally, a synchronous mass lesion in the sigmoid colon. The patient underwent an emergency EVAR using a Gore Excluder endograft. Postoperative CT staging for colon cancer revealed a type 2 endoleak on the grounds of a patent wide inferior mesenteric artery. The patient underwent a standard laparoscopic left colectomy with high ligation of the inferior mesenteric artery in order to simultaneously address the ongoing type 2 endoleak. Follow-up examinations with computed tomographic angiography were performed confirming the resolution of the endoleak. Synchronous laparoscopic sigmoidectomy and high ligation of inferior mesenteric artery for type 2 endoleak treatment appears to be applicable with hopeful results.