Robotic abdominoperineal resection, posterior vaginectomy and abdomino-lithotomy sacrectomy: technical considerations and case vignette.

Autor: Kearsey CC; Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK. cck1@doctors.org.uk.; Institute of Translational Medicine, University of Liverpool, Liverpool, UK. cck1@doctors.org.uk.; Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK. cck1@doctors.org.uk., Mathur M; Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK., Sutton PA; Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK.; Division of Cancer Sciences, University of Manchester, Manchester, UK., Selvasekar CR; Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, UK.; Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK.
Jazyk: angličtina
Zdroj: Techniques in coloproctology [Tech Coloproctol] 2023 Nov; Vol. 27 (11), pp. 1125-1130. Date of Electronic Publication: 2023 Jul 15.
DOI: 10.1007/s10151-023-02827-w
Abstrakt: When working with patients who have locally advanced rectal cancer (LARC) the ability to undertake minimally invasive procedures becomes more challenging but no less important for patient outcomes. We performed a minimally invasive approach to surgery for LARC invading the posterior vagina and sacrum. The patient was a 75-year-old lady who presented with a locally advanced rectal tumour staged T4N2 with invasion into the posterior wall of the vagina and coccyx/distal sacrum. We introduce a robotic abdominoperineal resection, posterior vaginectomy and abdomino-lithotomy sacrectomy using a purely perineal approach with no robotic adjuncts or intracorporal techniques. Final histology showed moderately differentiated adenocarcinoma invading the vagina and sacrum, ypT4b N0 TRG2 R0 and the patient entered surgical follow-up with no immediate intra- or postoperative complications. A literature review shows the need for more minimally invasive techniques when relating to major pelvic surgery and the benefits of a purely perineal approach include less expensive resource use, fewer training requirements and the ability to utilise this technique in centres that are not robotically equipped.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz: