Implementation of robot-assisted curative resection for rare anorectal tumours on the basis of individualised treatment.

Abstract

To evaluate the validity of robot-assisted curative operation for rare anorectal tumours, characterised by biological heterogeneity and anatomical complexity. The present study evaluated 16 consecutive patients including three with anorectal squamous cell carcinoma (ARSCC), four with anorectal mucosal melanoma (ARMM), seven with anorectal neuroendocrine tumour (ARNET), and two with other types of anorectal tumours. Of the three patients with ARSCC after chemoradiotherapy, two underwent abdominoperineal resection (APR), and one underwent ultralow anterior resection (uLAR)/total intersphincteric resection (ISR), surviving 56-76months without recurrence. Of the four ARMM patients, APR and uLAR/total ISR were conducted in two patients, respectively, with variable survival outcomes. All seven patients with ARNET were treated with uLAR/ISR and LAR, surviving for 5-106months to date. Because most anorectal tumours are confined to the dermal and submucosal layers, robotic anorectal function preserving ISR is expected to achieve R0 resection.