引用文本：王利明, 王洋洋, 关剑, 等. 机器人辅助下直肠肛门恶性黑色素瘤腹会阴联合切除术1例[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(3): 473-477.

作者：王利明1，王洋洋1，关剑2，任培德1，陈瑛罡1

单位：1. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院 胃肠外科，广东 深圳 518116；2. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院 病理科，广东 深圳 518116

Authors：Wang Liming1, Wang Yangyang1, Guan Jian2，Ren Peide1, Chen Yinggang1

Unit：1. Department of Gastrointestinal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong, China；2. Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong, China

摘要：

直肠肛门恶性黑色素瘤（anorectal malignant melanoma, ARM）是罕见且高度侵袭性的黏膜恶性肿瘤，具有误诊率高、预后差的特点。本文报道1例68岁男性多发ARM患者，以便血为主要表现，肠镜见直肠下段3处黑色病灶，影像学提示T₂N₀期。患者接受达芬奇 Xi系统辅助腹会阴联合切除术（abdominoperineal resection, APR）+D3淋巴结清扫，术后病理证实为pT_1bN₀M₀期、原发多中心ARM，切缘阴性，无脉管神经侵犯。患者术后恢复顺利，无并发症发生，短期随访未见复发。本例提示，多发ARM更倾向于原发多中心起源，APR是其根治性切除的优选术式；机器人手术在盆腔深部的操作具有精准、微创、安全的特点，可为ARM外科治疗提供重要参考。

关键词：直肠肛门黑色素瘤；机器人手术；腹会阴联合切除术

Abstract：

Anorectal malignant melanoma (ARM) is a rare, highly aggressive mucosal malignancy with a high misdiagnosis rate and poor prognosis. We report a 68-year-old male patient with multifocal ARM, presenting with hematochezia. Colonoscopy revealed three black lesions in the lower rectum, and imaging suggested clinical T₂N₀ stage. The patient underwent da Vinci Xi robot-assisted abdominoperineal resection (APR) with D3 lymphadenectomy. Postoperative pathology confirmed pT_1bN₀M₀ primary multicentric ARM, with negative margins and no vascular/perineural invasion. The patient recovered smoothly postoperatively without any complications, and no recurrence was observed during short-term follow-up. This case indicates that multifocal ARM tends to be primary multicentric, and APR is the preferred radical procedure. Robotic surgery offers precise operation in the deep pelvic cavity, with minimal invasiveness and safety, providing an important reference for the surgical management of ARM.

Key words：Anorectal malignant melanoma; Robot-assisted surgery; Abdominoperineal resection

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