Young Patient with Advanced Low Rectal Cancer Successfully Treated with Robotic Sphincter-Preserving Surgery at Fortis Hospital Mulund

Clinical Presentation

A young man in his twenties working abroad presented with persistent rectal bleeding. Investigations revealed a locally advanced low rectal cancer located just 4 cm from the anal verge. The diagnosis raised significant concerns regarding future fertility, quality of life, and long-term functional outcomes.

Procedure

Following fertility preservation through semen banking, the patient underwent neoadjuvant treatment with FOLFIRINOX chemotherapy followed by radiation therapy. Although the tumour showed significant regression, residual disease remained, necessitating surgery.
A robotic intersphincteric dissection with coloanal reconstruction was successfully performed, achieving complete cancer removal while preserving bowel, urinary, and sexual function.

Postoperative Outcome

The patient recovered well and was discharged within four days of surgery. Urinary and sexual functions were preserved, and bowel continuity was maintained with only a temporary protective stoma.

Result

The temporary stoma was successfully reversed three months later. The patient returned to work abroad, resumed his normal routine, and regained an active lifestyle.

Conclusion

This case highlights the importance of specialised multidisciplinary care in managing complex rectal cancers. Advanced robotic surgery helped achieve excellent oncological and functional outcomes, allowing the patient to return to an active and independent lifestyle.