[COMBINED SURGERY FOR RECTAL CANCER WITH PROSTATIC INVASION : A CASE REPORT].

Area of Science:

• Oncology
• Urology
• Surgical Innovation

Background:

• Locally advanced rectal cancer with prostate invasion presents complex surgical challenges.
• Traditional surgical approaches carry significant risks of vesicourethral leakage and incontinence due to prostate and seminal vesicle resection.

Purpose of the Study:

• To evaluate the feasibility and outcomes of combining robotic abdominoperineal resection (APR) with retzius-sparing robot-assisted radical prostatectomy (RS-RARP) for rectal cancer invading the prostate.
• To assess the oncologic and functional results, particularly urinary continence and surgical margins.

Main Methods:

• A 58-year-old male patient with locally advanced rectal cancer invading the prostate underwent combined robotic surgery.
• Procedures included robotic abdominoperineal resection and retzius-sparing robot-assisted radical prostatectomy.
• Postoperative assessment included cystography and evaluation for urinary incontinence.

Main Results:

• The patient experienced an uneventful postoperative course with no vesicourethral anastomotic leakage or urinary incontinence.
• Pathological findings confirmed prostate invasion with negative surgical margins.
• No recurrence was observed at one-year follow-up after adjuvant chemotherapy.

Conclusions:

• Retzius-sparing robot-assisted radical prostatectomy combined with abdominoperineal resection is a feasible surgical option for selected patients with rectal cancer invading the prostate.
• This combined approach may offer a balance between achieving curative oncologic resection and preserving functional outcomes, including urinary continence.