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PubMed1975

Complications of surgery of the abdominal aorta.

Surgery of the aorta has become a routine since Astley Cooper first attempted to ligate the aorta. It is major surgery that requires careful technic, understanding of the disease process, and a full knowledge of the complications that may ensue. Most of the complications are preventable, and if the operator recognizes their possibility, most can be prevented. When complications occur, the operator must be prepared to handle them immediately since most of them are catastrophic and usually life-threatening to the patient. Surgery of the aorta should never be performed in a hospital that does not have the backup facilities to manage these complications. This requires the immediate availability of large quantities of blood and the various clotting factors that may be necessary in some patients. In addition, arteriography must be available constantly and on a moment's notice, because it is often necessary in making the diagnosis. Finally, a good intensive care unit with skilled respiratory therapists is mandatory in handling the complications of this type of operation. Many such patients have had at least one myocardial infarction before operation on the aorta and many of the complications will lead to massive distension of the abdomen with high diaphragm, atelectasis, and the need for continual respiratory care if the patient is to survive.

Animals↗
PubMed1980

Resection of the abdominal aorta for recurrent colon cancers. 18 year survival.

(1) An 18 year survival after resection of a recurrent colon cancer involving the aortic bifurcation is reported. (2) Involvement of major intraabdominal vessels by malignant tumors should not categorically be considered a contraindication to curative resection. (3) After extended radical resections for colonic cancer, 40 to 100 percent of the adhesions will contain malignant cells. Curative en bloc resection of these primary tumors together with their organs and tissues, particularly if the adhesions are dense, can achieve 5 year survival in 34 percent of cases. (4) Colonic tumors recur locally in 4 to 28 percent of patients who are resected for cure; recurrence at the primary site may be the sole evidence of recurrent disease in 28 to 60 percent of these cases. These patients may be candidates for exploratory laparotomy and 30 to 40 percent may be amenable to reresection for cure with an anticipated 5 year survival rate of 23 percent.

Adenocarcinoma↗
PubMed1991

Collagen stability and collagenolytic activity in the normal and aneurysmal human abdominal aorta.

Two issues were addressed in this study. The first was whether a bona fide collagenase exists within the wall of the aorta. The second was whether the activity of this putative collagenase is greater in aneurysmal tissue. No collagenase could be extracted from the wall of the aorta under nondenaturing conditions. However, hydroxyproline was liberated from tissue samples allowed to autolyze at neutral pH under reaction conditions favoring the activity of collagenase. Such an activity was probably enzymic as it occurred in a time- and temperature-dependent fashion and was suppressed by chelators. In normal and stenotic tissue, activity was increased by adding aminophenylmercuric acetate, an activator of latent collagenase. Examination of the blanks revealed that the collagen of aneurysmal aorta was more soluble than normal. Furthermore, its digestion kinetics differed in a way that suggested that aneurysmal aorta possessed a labile component that was absent from normal tissue. Although the activity of the putative aortic collagenase was higher than normal in the aneurysmal tissue, our assays do not distinguish between changes in the amount or activity of the enzyme and alterations in the collagen.

Adult↗