First Report: Robot-Assisted Total Pelvic Exenteration for Locally Advanced Prostate Cancer.

Abstract

Pelvic exenteration is used in the treatment of several pelvic cancers, including those of the rectum, uterus, and bladder. We report the first case of robotic pelvic exenteration for the treatment of symptomatic prostate cancer involving the rectum and bladder. A six-port transperitoneal robotic approach was used. Bilateral extended lymphadenectomy up to the inferior mesenteric artery was performed. The rectum and bladder were removed en bloc, and a double-barrel anastomosis was then performed with both ureters being connected to the lower opening of the colostomy. Operative time was 249 minutes, and estimated blood loss was 600 mL. No intraoperative or postoperative complications were recorded. Biopsy of the rectum and bladder showed prostatic adenocarcinoma with a Gleason score of 9 (5+4), and 1 of 17 nodes was positive for cancer. Postoperative prostate-specific antigen level was 1.24 ng/mL. The patient is already 19 months after surgery with optimal quality of life. Thus pelvic exenteration is a feasible alternative for highly symptomatic prostate cancer involving adjacent pelvic organs.

• Authors: Octavio A Castillo, Ivar Vidal-Mora, Arquimedes Rodriguez-Carlin, Andres Silva, Oscar Schatloff
• Journal: Journal of laparoendoscopic & advanced surgical techniques. Part A (J Laparoendosc Adv Surg Tech A) Vol. 25 Issue 7 Pg. 592-4 (Jul 2015) ISSN: 1557-9034 [Electronic] United States
• PMID: 26134069 (Publication Type: Case Reports, Journal Article)

Topics

• Adenocarcinoma (secondary, surgery)
• Aged
• Humans
• Lymph Node Excision
• Lymphatic Metastasis
• Male
• Operative Time
• Pelvic Exenteration (adverse effects, methods)
• Pelvis
• Prostatic Neoplasms (pathology, surgery)
• Rectal Neoplasms (secondary, surgery)
• Robotic Surgical Procedures
• Urinary Bladder Neoplasms (secondary, surgery)