同步直肠和前列腺恶性肿瘤很少见，标准治疗指南尚未建立。1-3 机器人直肠和前列腺联合手术代表了治疗同时直肠和前列腺恶性肿瘤的潜在优秀方法，具有微创手术的优势。4 方法：一名 78 岁男性，有高血压和 2 型糖尿病病史，出现 3 个月的便痛和排尿困难。诊断性结肠镜检查发现直肠前壁距肛缘 3 厘米处粘膜下肿块，癌胚抗原和前列腺特异性抗原水平异常。盆腔计算机断层扫描（CT）显示直肠肿块和前列腺之间的界限不明确，表明存在潜在的侵​​袭。 CT 引导下活检证实为直肠胃肠道间质瘤 (GIST) 和前列腺腺泡腺癌。经过 3 个月的甲磺酸伊马替尼和比卡鲁胺新辅助治疗，肿瘤显着缩小。5 随后，患者同步接受机器人保肛直肠切除术和前列腺切除术，首先进行前列腺切除，然后进行直肠肿瘤切除，最后进行肠道重建和前列腺切除术。采用连续缝合技术进行膀胱尿道吻合术。手术时间为 220 分钟，预计失血量为 50 mL。未遇到手术并发症，所有切除边缘均无肿瘤，表明切除完全。患者恢复良好，术后第七天出院。 3 个月的随访显示没有复发或功能障碍的证据。对于同步直肠 GIST 和前列腺癌的病例，在新辅助治疗后可以可行且安全地进行机器人同步保留括约肌局部直肠切除术和前列腺切除术。© 2024。Society of Surgical肿瘤学。

Synchronous rectal and prostate malignancies are rare and standard treatment guidelines have not yet been established.1-3 Combined robotic rectal and prostate surgery represents a potentially excellent approach for managing synchronous rectal and prostate malignancies, offering the advantages of a minimally invasive procedure.4 METHODS: A 78-year-old male with a history of hypertension and type 2 diabetes presented with 3 months of dyschezia and dysuria. Diagnostic colonoscopy revealed a submucosal mass 3 cm from the anal verge in the anterior wall of the rectum, with abnormal carcinoembryonic antigen and prostate-specific antigen levels. Pelvic computed tomography (CT) indicated indistinct boundaries between the rectal mass and the prostate, suggesting potential invasion. CT-guided biopsies confirmed a rectal gastrointestinal stromal tumor (GIST) and prostatic acinar adenocarcinoma. After 3 months of neoadjuvant therapy with imatinib mesylate and bicalutamide, significant tumor reduction was achieved.5 Subsequently, the patient underwent simultaneous robotic sphincter-preserving rectal resection and prostatectomy, starting with the prostatectomy, followed by rectal tumor excision and ending with bowel reconstruction and vesicourethral anastomosis using a running suture technique.The operation time was 220 min and the estimated blood loss was 50 mL. No surgical complications were encountered and all resected margins were free of tumor, indicating a complete excision. The patient recovered well and was discharged on the seventh postoperative day. Follow-up at 3 months showed no evidence of recurrence or functional impairments.Simultaneous robotic sphincter-preserving local rectal resection and prostatectomy can be feasibly and safely performed following neoadjuvant therapy in cases of synchronous rectal GIST and prostate cancer.© 2024. Society of Surgical Oncology.