Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Asian J Endosc Surg. 2022 Jul;15(3):678-682. doi: 10.1111/ases.13048. Epub 2022 Mar 13.
Few studies have reported the simultaneous resection of synchronous rectal and prostate cancers. Here, we report five patients undergoing simultaneous robotic-assisted laparoscopic surgery (RALS) for synchronous rectal and prostate cancer. Rectal cancer operative procedures were high anterior (n =1), intersphincteric (n =2), or abdominoperineal (n =2) resection, followed by radical prostatectomy with vesico-urethral anastomosis. There were no conversions to open surgery, with R0 resection achieved for all rectal cancer cases. The median operative time was 629 (range, 431-764) minutes, and the median estimated blood loss was 100 (range, 20-345) mL. There was one case of colorectal anastomotic leakage requiring covering ileostomy, and two cases of vesico-urethral anastomotic leakage requiring Foley catheter reinsertion. Ileostomies were finally closed in all patients. Pad-free or safety-pad usage for post-surgical urinary incontinence at 6 and 12 months was 3/5 and 5/5, respectively. Simultaneous RALS for synchronous rectal and prostate cancer may offer a safe and feasible approach in selected patients.
很少有研究报告同时切除直肠和前列腺癌。在这里，我们报告了 5 例同时接受机器人辅助腹腔镜手术（RALS）治疗直肠和前列腺癌的患者。直肠肿瘤手术程序为高位前切除术（n=1）、经括约肌间切除术（n=2）或腹会阴切除术（n=2），随后进行根治性前列腺切除术和膀胱尿道吻合术。没有转为开放性手术，所有直肠肿瘤病例均达到 R0 切除。中位手术时间为 629 分钟（范围，431-764 分钟），中位估计出血量为 100 毫升（范围，20-345 毫升）。有 1 例发生结直肠吻合口漏，需行保护性回肠造口术，2 例发生膀胱尿道吻合口漏，需重新插入 Foley 导管。所有患者最终都关闭了回肠造口。在术后 6 个月和 12 个月，无尿失禁垫或安全垫使用的分别为 3/5 和 5/5。在选定的患者中，同期 RALS 治疗直肠和前列腺癌可能是一种安全可行的方法。
