Kyoichi Kihara1, Yuri Koyama2, Takehiko Hanaki3, Kozo Miyatani3, Tomoyuki Matsunaga3, Manabu Yamamoto3, Shuichi Morizane2, Naruo Tokuyasu3, Teruhisa Sakamoto3, Yoshiyuki Fujiwara3. 1. Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori, 683-8504, Japan. kyo1kihara@tottori-u.ac.jp. 2. Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori, 683-8504, Japan. 3. Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori, 683-8504, Japan.
Abstract
BACKGROUND: There are numerous indications for minimally invasive surgery. However, the laparoscopic approach for extended pelvic surgery is currently provided by only a few institutions specializing in cancer treatment, primarily because of technical difficulties that arise in cases involving a narrow pelvis and rigid forceps. We report a case of robot-assisted total pelvic exenteration for rectal cancer involving the prostate. We assessed the feasibility of robot-assisted total pelvic exenteration and compared the short-term outcomes of other conventional and minimally invasive approaches. CASE PRESENTATION: A 67-year-old man was referred to our hospital after positive fecal blood test results. The initial diagnosis was clinical T4bN2aM0, Stage IIIC rectal cancer involving the prostate. The patient underwent neoadjuvant chemoradiotherapy. Consequently, robot-assisted total pelvic exenteration with an ileal conduit and end colostomy creation were performed. The total operative duration was 9 h and 20 min. The durations of robot console usage by the colorectal and urological teams were 2 h 9 min and 2 h 23 min, respectively. The patient was discharged on postoperative day 21. The pathological diagnosis was T4b (prostate) N0M0, Stage IIC. The resection margin was 2.5 mm. During reassessment at 2 years after resection, no evidence of recurrence was observed. CONCLUSIONS: Robot-assisted total pelvic exenteration was performed for a patient with advanced rectal cancer without serious complications. Robot-assisted total pelvic exenteration may provide the advantages of minimally invasive surgery, particularly in the enclosed space of the pelvis.
BACKGROUND: There are numerous indications for minimally invasive surgery. However, the laparoscopic approach for extended pelvic surgery is currently provided by only a few institutions specializing in cancer treatment, primarily because of technical difficulties that arise in cases involving a narrow pelvis and rigid forceps. We report a case of robot-assisted total pelvic exenteration for rectal cancer involving the prostate. We assessed the feasibility of robot-assisted total pelvic exenteration and compared the short-term outcomes of other conventional and minimally invasive approaches. CASE PRESENTATION: A 67-year-old man was referred to our hospital after positive fecal blood test results. The initial diagnosis was clinical T4bN2aM0, Stage IIIC rectal cancer involving the prostate. The patient underwent neoadjuvant chemoradiotherapy. Consequently, robot-assisted total pelvic exenteration with an ileal conduit and end colostomy creation were performed. The total operative duration was 9 h and 20 min. The durations of robot console usage by the colorectal and urological teams were 2 h 9 min and 2 h 23 min, respectively. The patient was discharged on postoperative day 21. The pathological diagnosis was T4b (prostate) N0M0, Stage IIC. The resection margin was 2.5 mm. During reassessment at 2 years after resection, no evidence of recurrence was observed. CONCLUSIONS: Robot-assisted total pelvic exenteration was performed for a patient with advanced rectal cancer without serious complications. Robot-assisted total pelvic exenteration may provide the advantages of minimally invasive surgery, particularly in the enclosed space of the pelvis.
Authors: S Tsukamoto; S Fujita; M Ota; J Mizusawa; D Shida; Y Kanemitsu; M Ito; A Shiomi; K Komori; M Ohue; Y Akazai; M Shiozawa; T Yamaguchi; H Bando; A Tsuchida; S Okamura; Y Akagi; N Takiguchi; Y Saida; T Akasu; Y Moriya Journal: Br J Surg Date: 2020-03-12 Impact factor: 6.939
Authors: Willem van Gijn; Corrie A M Marijnen; Iris D Nagtegaal; Elma Meershoek-Klein Kranenbarg; Hein Putter; Theo Wiggers; Harm J T Rutten; Lars Påhlman; Bengt Glimelius; Cornelis J H van de Velde Journal: Lancet Oncol Date: 2011-05-17 Impact factor: 41.316