同时进行机器人括约肌的直肠切除和前列腺切除术，用于直肠胃肠道肿瘤和前列腺癌
Simultaneous Robotic Sphincter-Preserving Rectal Resection and Prostatectomy for Rectal Gastrointestinal Stromal Tumor and Prostatic Cancer
影响因子:3.50000
分区:医学2区 / 外科2区 肿瘤学3区
发表日期:2024 Nov
作者:
Anqi Wang, Anbang Wang, Xinyun Xu, Ming Chen, Haiyang Zhou
摘要
同步直肠和前列腺恶性肿瘤很少见，尚未确定标准治疗指南。1-3机器人直肠和前列腺手术组合是一种潜在的出色方法，可用于管理同步和前列腺恶性肿瘤，并提供最小侵入性手术的优势。动力学和排尿障碍。诊断结肠镜检查显示，直肠前壁的肛门边缘有3厘米的粘膜粘膜质量，具有异常的癌腹抗原和前列腺特异性抗原水平。骨盆计算机断层扫描（CT）表明直肠质量和前列腺之间的边界不明显，表明潜在的浸润。 CT引导的活检证实了直肠胃肠道肿瘤（GIST）和前列腺腺泡腺癌。在用伊马替尼甲酸酯和dicalutamide进行了3个月的新辅助治疗后，实现了显着减少的肿瘤。5随后，患者接受了同时进行机器人括约肌的直肠外直肠切除术和前后切除术，并从前列腺切除术开始，然后使用直肠肿瘤进行了旋律，并进行了旋律，并进行了连续性疾病，并进行了连续性疾病。技术。手术时间为220分钟，估计失血为50 mL。没有遇到手术并发症，所有切除的边缘都没有肿瘤，表明切除了完全切除。患者康复良好，并在术后第七天出院。 3个月的随访没有显示出复发或功能障碍的证据。在新辅助治疗后，在同步直肠GIST和前列腺癌的情况下，在新辅助治疗后，可以可行，安全地进行机器人括约肌固定局部直肠切除术和前列腺切除术。
Abstract
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.