Case report demonstrates effective treatment of metastatic anal fistula carcinoma in a complex surgical scenario, suggesting feasibility of advanced robotic techniques.
INTRODUCTION: Robot-assisted surgery has become an established approach for rectal cancer, offering favorable short-term outcomes and oncologic results comparable to conventional laparoscopic surgery. With recent technological advances, its use has expanded to more complex scenarios, including reoperative surgery with severe adhesions or distorted pelvic anatomy. Metastatic anal fistula carcinoma is uncommon, and its surgical management is challenging, particularly in patients with prior rectal surgery because of severe adhesions and distorted pelvic anatomy. We report a rare case of metastatic carcinoma associated with an anal fistula that developed after curative resection of rectosigmoid cancer and was treated with robot-assisted abdominoperineal resection (R-APR) and gluteal myocutaneous flap reconstruction.
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Kunitomo et al. (2026) studied this question.
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