Robotic Subtotal Colectomy with en-bloc Resection of the Left Chest wall for Locally Advanced Colonic Cancer: A Case Report and Literature Review

Abstract Locally advanced colonic cancers requiring multivisceral en-bloc resections are typically undertaken in an open or laparoscopic approach. Here, we report a case of a complex robotic subtotal colectomy with en-bloc resection of the chest wall and left 10th to 12th ribs for management of a locally advanced descending colon cancer and peritumoral abscess at our institution in June 2020. The procedure was augmented with intraoperative ultrasound scan-guided marking to delineate tumoural extent. Histologically, negative excision margins (R0) were achieved. We also undertook a brief review of relevant literature. There are very few publications on the multivisceral resections for advanced colonic cancer; this is the second reported case of robotic en-bloc colonic resection in English literature. A similar case report published in 2019 enforced the value of multidisciplinary team collaboration and the benefits of robotic over laparoscopic surgery in en-bloc resections. Considering improved short-term outcomes and comparable oncological safety granted by laparoscopic surgery, minimally-invasive surgery has a clear role in the surgical management of locally-advanced colorectal cancers. Key words: en-bloc resection, multivisceral resection, colonic cancer, robotic surgery, subtotal colectomy, peritumoural abscess