In a breakthrough surgical feat, doctors at Aster RV Hospital have successfully treated a rare and complex case of low rectal carcinoma in a Dubai-based patient of Indian origin—preserving the anal sphincter and sparing the patient from a lifelong colostomy bag.

The case had initially appeared bleak. At other medical centres, the patient was advised total removal of the anal sphincter, which would have meant permanent reliance on a colostomy. However, at Aster RV’s multidisciplinary oncology clinic, specialists decided to explore a more patient-centric approach. A comprehensive diagnostic work-up was carried out—including MRI, PET-CT, biopsy, and advanced tumour genomic profiling (KRAS, NRAS, BRAF).

Based on these results, the surgical, medical, and radiation oncology teams opted for a neoadjuvant treatment plan involving chemoradiation, with the patient and family actively engaged in the decision-making process.

“Sphincter preservation in very low rectal cancers is one of the most complex goals in surgical oncology, as it directly impacts a patient’s quality of life,” said Dr. Jagannath Dixit, Senior Consultant – Surgical Oncology, Aster RV Hospital. “Through meticulous planning, advanced technology, and a multidisciplinary approach, we were able to achieve both oncological safety and functional preservation. This case reflects our philosophy of combining patient-centric decision-making with cutting-edge surgical techniques.”

The patient underwent five weeks of chemoradiation followed by nine weeks of metronomic chemotherapy. Post-treatment scans showed significant tumour shrinkage, making surgery feasible. The surgical team then performed a robotic-assisted ultra-low anterior resection with hand-sewn coloanal anastomosis and a temporary ileostomy.

Recovery was swift and uneventful, with preserved continence and normal functions—outcomes rarely achieved in such low rectal cancer cases.

The success not only highlights the benefits of robotic-assisted surgery and genomic profiling but also underscores the importance of multidisciplinary collaboration in improving cancer care and quality of life for patients facing challenging diagnoses.