Thoracoabdominal aneurysm resection after previous infrarenal abdominal aortic aneurysmectomy

Article Abstract:

Most patients who undergo aortic reconstruction as a result of abdominal aortic aneurysm (localized thinning and weakening of the wall of the abdominal portion of the main trunk of the systemic artery) have good long-term outcomes. However, some patients may later develop aneurysm of the thoracoabdominal aorta (that is, the segment in the chest and abdomen) and require further aortic surgery many years later. Over a five-year period 51 patients underwent surgery for thoracoabdominal aneurysm, 14 of whom (27 percent) had undergone a prior infrarenal aneurysm repair. A report is presented of these 14 patients. Their average age was 67 and the average time interval between initial aneurysm surgery and thoracoabdominal aneurysm repair was 8.5 years. All patients had hypertension; 93 percent smoked, 78 percent had arteriosclerotic heart disease and 50 percent had suffered myocardial infarction. Three patients required emergency surgery, two for ruptured aneurysm. There were four deaths (28 percent). Death within 30 days of surgery was related to age over 72; there was 75 percent mortality in that age group, compared with 10 percent for patients under 72. Other factors predictive of death were: extent of aneurysm above the diaphragm; aneurysm rupture; and history of heart attack, congestive heart failure or heart rhythm irregularities. With the exception of extent of aneurysm, these prognostic factors were similar to those found in the larger group of all 51 patients who underwent thoracoabdominal aneurysm repair. These findings indicate that there is no increased morbidity or mortality associated with thoracoabdominal aneurysm repair following previous aortic aneurysm repair. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Aortic aneurysms, Aortic aneurysm, Abdominal aneurysm, Abdominal aortic aneurysm

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Effect of antitumor surgery on soluble interleukin-2 receptor serum levels

Article Abstract:

Surgery can reduce the body's immune defenses. This immunosuppression may play a role in cancer relapse in patients having surgery to remove tumors. Micrometastases (microscopic spread of cancer) may be present, although undetected, at the time of surgery that is performed to remove the tumor. Production of interleukin-2 (IL-2) is important in the stimulation of most anti-cancer immune reactions which seem to be able to destroy fresh cancer cells. The ability of IL-2 to stimulate the immune system depends on its action on specific IL-2 receptors. Patients with widespread solid cancers have been noted to have abnormally high blood levels of a soluble type of interleukin-2 receptor. A study was undertaken to determine the influence of surgery on soluble interleukin-2 receptor serum levels in patients with solid tumors. There were 48 patients who underwent surgery for cancer and 11 controls without cancer who underwent major surgery. Serum levels of soluble interleukin-2 receptor were evaluated before and seven days after surgery; in both patient groups, the average serum levels were significantly higher after surgery than before. Due to the capacity of soluble interleukin-2 receptors to bind to interleukin-2, the increased levels of soluble interleukin-2 receptors may reduce availability of interleukin-2 and thus have a negative impact on immune function involving interleukin-2 that is directed against tumors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Risk factors, Physiological aspects, Cancer, Metastasis, Cancer metastasis, Interleukin-2, Drug receptors

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