Introduction: Renal carcinoma (RC) is present in 0.1-3% of patients with abdominal aortic aneurysm (AAA). There are several options for surgical solution as regards the type and timing of the procedure. The authors discuss the simultaneous AAA resection and radical nephrectomy as a treatment option.
Material and methods: 1168 patients with AAA including 19 (1.6%) with asymptomatic AAA (diameter >50mm) and RC (average diameter 74.3 mm) indicated for radical nephrectomy were operated on in the last 20 years (between 5/1994 and 5/2014). The average age of the patients was 72.8 years (5585). Pre-operatively, sixteen patients were classified as ASA II, three as ASA III. Unilateral nephrectomy was performed in 18 and bilateral nephrectomy in one patient. One-stage AAA resection (1x endovascular aneurysm repair) with nephrectomy was performed in all patients.
Results: Two patients with ASA III classification died within 30 days postoperatively due to acute myocardial infarction and multiorgan failure. In the other patients, the simultaneous procedure was without any complications. Four patients died within two years after the operation due to generalized RC, the others have survived in the interval of one and twelve years after the procedure.
Conclusion: Simultaneous procedure does not represent increased operation load for patients with good health status. Nevertheless, the type of procedure should be optimised for each individual patient with regard to his or her general health status, life expectancy, disease symptomatology, the diameter of the RC and the anatomical conditions of AAA.