[A Case of Robot-Assisted Abdominoperineal Resection with Prostatectomy for Locally Advanced Rectal Cancer].

Journal: Gan to kagaku ryoho. Cancer & chemotherapy
PMID:

Abstract

The patient was referred to our hospital because of bloody stool and anorectal pain, and a colonoscopy revealed a tumor in the lower rectum. Although no distant metastasis was found, the tumor was suspected to have invaded the distal prostate. Neoadjuvant chemoradiotherapy(45 Gy/25 Fr with S-1)resulted in tumor shrinkage and symptomatic improvement, however, the primary tumor remained in close proximity to the prostate and urethra. Thus, we performed a robot-assisted abdominoperineal resection and Retzius-sparing prostatectomy in collaboration with the urology department. The surgical margins were negative and radical resection was achieved. Although minor vesicourethral anastomotic leakage was observed, it recovered conservatively. The patient has been alive 1 year postoperatively without recurrence. The patient initially had urinary incontinence, but it gradually improved. Although a total pelvic resection could have been considered, the robot-assisted surgery made it possible to preserve the urinary tract. The future application of robot-assisted surgery in extended surgery is expected.

Authors

  • Tatsushi Saito
    Dept. of Surgery, Tohoku University Graduate School of Medicine.
  • Hideaki Karasawa
  • Naoki Kawamorita
    Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Hidetaka Ichikawa
  • Tomoyuki Ono
  • Minoru Kobayashi
  • Taiki Kajiwara
  • Atsushi Kohyama
  • Kazuhiro Watanabe
    Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Takashi Kamei
  • Shinobu Onuma
  • Akihiro Ito
    Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Michiaki Unno
    Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.