Laparoscopy-assisted distal gastrectomy in a case of gastric cancer with situs inversus totalis: a case report

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• 作者：Yu Kigasawa ; Hiroya Takeuchi ; Hirofumi Kawakubo ; Kazumasa Fukuda ; Rieko Nakamura ; Tsunehiro Takahashi ; Norihito Wada and Yuko Kitagawa
• 刊名：Asian Journal of Endoscopic Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：10
• 期：1
• 页码：47-50
• 全文大小：306K
• ISSN：1758-5910

文摘

Situs inversus totalis (SIT) is a rare congenital condition in which abdominal and thoracic organs are transposed from normal positions. Laparoscopy-assisted distal gastrectomy for situs inversus totalis is technically difficult and has rarely been reported. Here, we report the case of man in his 40s with situs inversus totalis and a preoperative diagnosis of stage IA gastric cancer (cT1b, cN0, cM0). We successfully performed laparoscopy-assisted distal gastrectomy with D1+ lymph node dissection and Billroth I reconstruction. To ensure a safe procedure, we evaluated the vessels preoperatively with 3-D CT angiography. Furthermore, we performed the surgery by reversing our surgical positions, using a two-monitor method, and then reconstructing under direct vision through the incision. The surgery was performed with minimal blood loss, and no severe postoperative complications were observed. Histopathological examination revealed poorly to moderately differentiated stage IA (pT1b, pN0, pM0) adenocarcinoma. No recurrence has been observed as of 2 years postoperatively.