Imasato Naoki, Yajima Shugo, Ogasawara Ryo A, Inoue Minoru, Hirose Kohei, Sekiya Ken, Kataoka Madoka, Nakanishi Yasukazu, Masuda Hitoshi
National Cancer Center Hospital East Chiba Japan.
IJU Case Rep. 2024 Oct 1;7(6):506-509. doi: 10.1002/iju5.12793. eCollection 2024 Nov.
There are often opportunities to consider treatment strategies for synchronous or metachronous prostate cancer with colorectal cancer. Performing robot-assisted radical prostatectomy for prostate cancer following previous rectal cancer surgery in cases involving anal-preserving surgeries such as low anterior resection or intersphincteric resection can be challenging because of the possibility of adhesions.
A 74-year-old man who had undergone laparoscopic intersphincteric resection for rectal cancer was diagnosed with prostate cancer. The patient desired to undergo robot-assisted radical prostatectomy. During surgery, we observed the absence of Denonvillier's fascia on the dorsal surface of the prostate, the intestinal anastomosis was distal to the vesicourethral anastomosis, and the rectum was replaced with a peristaltic sigmoid colon with minimal adhesions.
Periprostatic conditions vary depending on previous rectal surgical approaches. It is crucial to confirm the previous surgical approach for rectal cancer when performing robot-assisted radical prostatectomy following rectal cancer surgery.
对于同时性或异时性前列腺癌合并结直肠癌的情况，常常有机会考虑治疗策略。在涉及保留肛门手术（如低位前切除术或括约肌间切除术）的病例中，先前直肠癌手术后再行机器人辅助根治性前列腺切除术，由于存在粘连的可能性，可能具有挑战性。
一名74岁男性，曾接受腹腔镜括约肌间直肠癌切除术，后被诊断为前列腺癌。患者希望接受机器人辅助根治性前列腺切除术。手术过程中，我们观察到前列腺背侧Denonvillier筋膜缺失，肠吻合口位于膀胱尿道吻合口远端，直肠被蠕动的乙状结肠替代，粘连极少。
前列腺周围情况因先前直肠手术方式而异。直肠癌手术后行机器人辅助根治性前列腺切除术时，确认先前直肠癌的手术方式至关重要。
