Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India.
HBNI, Homi Bhabha National Institute, Mumbai, India.
ANZ J Surg. 2022 Oct;92(10):2595-2599. doi: 10.1111/ans.17888. Epub 2022 Jun 28.
Isolated seminal vesicle invasion is a rare occurrence in patients with locally advanced rectal cancers. This study describes the surgical technique and the perioperative outcomes of minimally invasive 'en-bloc' seminal vesicle excision, preserving the bladder and the prostate.
A retrospective review of 23 consecutive patients who underwent minimally invasive, en-bloc resection of seminal vesicles for locally advanced, non-metastatic rectal adenocarcinoma between May 2016 and November 2021. Perioperative outcomes and short-term oncological outcomes were defined.
Eighteen patients underwent a laparoscopic procedure while five received a robotic resection. All patients received preoperative radiation with or without consolidation chemotherapy. The median age was 42 years (range 20-64 years) and the median hospital stay was 8 days (range 3-19 days), respectively. Serious complications (Clavien-Dindo ≥ IIIb) were seen in six patients (26.1%). Two patients (8.7%) had an involved circumferential resection margin. At a median follow up of 19 months (range 2-52 months), four patients developed recurrences. The 2-year overall and disease-free survival was 84.4% and 73.6%, respectively.
Minimally invasive, en-bloc resection of one or both seminal vesicles for locally advanced rectal adenocarcinoma, is feasible in a select group of patients with acceptable morbidity and short-term outcomes.
孤立的精囊侵犯在局部进展期直肠癌患者中较为罕见。本研究描述了微创“整块”切除精囊的手术技术和围手术期结果，同时保留了膀胱和前列腺。
回顾性分析了 2016 年 5 月至 2021 年 11 月期间 23 例局部进展、非转移性直肠腺癌患者接受微创、整块切除精囊的病例。定义了围手术期结果和短期肿瘤学结果。
18 例患者接受腹腔镜手术，5 例患者接受机器人手术。所有患者均接受了术前放疗联合或不联合巩固化疗。中位年龄为 42 岁（范围 20-64 岁），中位住院时间为 8 天（范围 3-19 天）。6 例患者（26.1%）出现严重并发症（Clavien-Dindo≥IIIb）。2 例患者（8.7%）切缘受侵。中位随访 19 个月（范围 2-52 个月），4 例患者复发。2 年总生存率和无病生存率分别为 84.4%和 73.6%。
对于局部进展期直肠腺癌，选择合适的患者行微创、整块切除单侧或双侧精囊是可行的，其发病率和短期结果可接受。
