Floppy aortic graft reconstruction for germ cell tumor invasion of the infrarenal aorta.
Significant aortic invasion by metastatic nonseminomatous germ cell tumors can present difficult problems intraoperatively in attempted curative retroperitoneal lymph node dissection. Aortic replacement with Dacron graft has been a successful method of dealing with this predicament. We describe a new approach of intraoperative floppy aortic graft reconstruction in a young patient with testicular germ cell cancer in whom a 14 cm pseudoaneurysm involving the infrarenal aorta developed after four courses of preoperative chemotherapy. This technique prevents significant lower extremity and pelvic ischemia during resection of the aorta and retroperitoneal tumor while providing the urologic surgeon with excellent exposure and minimal interference from the aortic graft.
Jerius
John T
JT
Department of Surgery, Louisiana State University Health Sciences Center, Shreveport, 711063, USA. jjeriu@lsuhsc.edu
Elmajian
Donald A
DA
Rimmer
David M
DM
Spires
Kevin S
KS
D000328:Adult; D017541:Aneurysm, False / Q000209:etiology* / Q000601:surgery*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001012:Aorta, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D018237:Germinoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012086:Reoperation; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D019043:Vascular Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*