|
1
|
Valenzuela-Fuenzalida JJ, Martínez Hernández D, Milos-Brandenberg D, Koscina Z, Avila-Sepulveda R, Baez B, Perez-Jimenez D, Nova Baeza P, Orellana Donoso M, Bruna-Mejias A. Association between types of abdominopelvic cancer in patients with situs inversus total: Systematic review. Medicine (Baltimore) 2024; 103:e37093. [PMID: 38394506 PMCID: PMC11309613 DOI: 10.1097/md.0000000000037093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/05/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Situs inversus is a rare congenital anatomical variant that involves a group of anomalies regarding the arrangement of intrathoracic and intraabdominal organs. Being able to find in the abdominal region the liver, gallbladder, inferior vena cava, and head of the pancreas and ascending colon on the left side of the abdomen, while on the right side there is the spleen, the stomach, the body of the pancreas, the ligament of Treitz, descending colon among others. In this same way, the thoracic organs, lungs and heart, are changed in their position in a mirror translocation. METHODS We systematically searched MEDLINE, Web of Science, Google Scholar, CINAHL, Scopus, and LILACS; the search strategy included a combination of the following terms: "Situs inversus," "Situs inversus totalis," "Cancer," "Neoplasm," "Abdominopelvic regions," and "clinical anatomy." RESULTS Within the 41 included studies, 46 patients with situs inversus who had cancer, in addition to being found in this organ and in these regions, we also found as a result that the majority of the studies in the research were in stage II; finally, no one study could assert the direct relationship between the situs inversus totalis and the cancer. CONCLUSION If our hallmarks could make us think that more exhaustive follow-up of the stomach and other organs should be carried out in these patients, there could also be other predisposing factors for cancer, which is why more studies are suggested to give future diagnostic and treatment guidelines treatment.
Collapse
Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
- Departamento de Ciencias Química y Biológicas, Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago, Chile
| | | | | | - Zmilovan Koscina
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile
| | | | - Belen Baez
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile
| | - Daniela Perez-Jimenez
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Pablo Nova Baeza
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile
| | - Mathias Orellana Donoso
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile
- Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Alejandro Bruna-Mejias
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile
- Departamento de Ciencias y Geografía, Facultad de Ciencias Naturales y Exactas, Universidad de Playa Ancha, Valparaíso 2360072, Chile
| |
Collapse
|
|
2
|
Liu HB, Cai XP, Lu Z, Xiong B, Peng CW. Laparoscopy-assisted gastrectomy for advanced gastric cancer patients with situs inversus totalis: Two case reports and review of literature. World J Gastrointest Surg 2023; 15:2063-2073. [PMID: 37901733 PMCID: PMC10600769 DOI: 10.4240/wjgs.v15.i9.2063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/01/2023] [Accepted: 07/25/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Situs inversus totalis (SIT) is a rare condition in which the positions of abdominal and thoracic organs present a "mirror image" of the normal ones in the median sagittal plane. Although minimally invasive surgery has evolved to achieve laparoscopic gastrectomy for gastric cancer (GC) patients with SIT, it is difficult to perform lymphadenectomy (LND) in such a transposed anatomical condition. Herein, we report the cases of two patients with SIT who successfully underwent laparoscopy-assisted gastrectomy (LAG) with D2 LND. CASE SUMMARY Case 1: A 65-year-old man was admitted for intermittent abdominal pain and distension, occasional belching, and acid reflux for 4 mo. He was diagnosed with GC (cT3N1-2M0) with SIT. Before surgery, he had undergone four cycles of neoadjuvant chemotherapy and immunotherapy. Then, the patient was evaluated as having a partial response, and laparoscopy-assisted distal gastrectomy with D2 LND and Billroth II reconstruction were performed. The operation was performed successfully within 240 min with an estimated blood loss of 50 mL and no severe complications. The patient was discharged on postoperative day (POD) 9. Case 2: A 55-year-old man was admitted for upper abdominal distension with pain and discomfort after eating for 3 mo. He was diagnosed with GC (cT3N1M0) with SIT. He had a history of hypertension for more than 10 years; however, his blood pressure was well-controlled via regular medication. We performed laparoscopy-assisted total gastrectomy with D2 LND and Roux-en-Y reconstruction. The operation was performed successfully within 168 min with an estimated blood loss of 50 mL and no severe complications. The patient was discharged on POD 10. CONCLUSION LAG with D2 LND could be considered an accessible, safe, and curative procedure for advanced GC patients with SIT.
Collapse
Affiliation(s)
- Hong-Bo Liu
- Department of Gastrointestinal Surgery, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan Peritoneal Cancer Clinical Medical Center, Zhongnan Hospital of Wuhan University, Wuhan 430070, Hubei Province, China
- School of Nursing, Wuhan University, Wuhan 430070, Hubei Province, China
| | - Xiao-Peng Cai
- Department of Gastrointestinal Surgery, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan Peritoneal Cancer Clinical Medical Center, Zhongnan Hospital of Wuhan University, Wuhan 430070, Hubei Province, China
| | - Zhao Lu
- Department of Gastrointestinal Surgery, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan Peritoneal Cancer Clinical Medical Center, Zhongnan Hospital of Wuhan University, Wuhan 430070, Hubei Province, China
| | - Bin Xiong
- Department of Gastrointestinal Surgery, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan Peritoneal Cancer Clinical Medical Center, Zhongnan Hospital of Wuhan University, Wuhan 430070, Hubei Province, China
| | - Chun-Wei Peng
- Department of Gastrointestinal Surgery, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan Peritoneal Cancer Clinical Medical Center, Zhongnan Hospital of Wuhan University, Wuhan 430070, Hubei Province, China
| |
Collapse
|
|
3
|
Li Z, Zhang X, Tian L, Liu Z, Liao X, Qiu J, Wang G, Yan L, Wang X, Wang X, Liu R. Case Report: Transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy for gastric cancer in a patient with situs inversus totalis: with video. Front Oncol 2023; 13:1189948. [PMID: 37287912 PMCID: PMC10242047 DOI: 10.3389/fonc.2023.1189948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/09/2023] [Indexed: 06/09/2023] Open
Abstract
Because of its significant advantage of fast postoperative recovery, natural orifice specimen extraction surgery (NOSES) has attracted increasing attention worldwide. However, the NOSES in gastric cancer (GC) treatment still needs more clinical practice, especially for the rare anatomical anomaly. Situs inversus totalis (SIT) is a rare autosomal recessive anatomical anomaly with an incidence ranging between 1/8,000 and 1/25,000 births. We present a video of transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy performed in a 59-year-old woman known to have SIT. Preoperative investigations revealed that the patient had early GC at the antrum. A gastroscopy report from the local hospital showed signet-ring cell carcinoma. The preoperative computed tomography scan revealed irregular thickening of the gastric wall at the junction of the greater curvature and antrum without metastasis to the lymph nodes. In total, laparoscopic D2 distal gastrectomy was performed with transvaginal specimen extraction. Billroth II with Braun anastomosis was performed for reconstruction. The length of the operation was 240 min without intraoperative complications and with minimal blood loss of 50 ml. The patient was uneventfully discharged on postoperative Day 7. The final pathology confirmed signet-ring cell carcinoma confined to the mucosal muscle without metastasis in 16 lymph nodes. Transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy can be safely performed in patients with SIT and has similar surgical outcomes to usual laparoscopic gastrectomy.
Collapse
Affiliation(s)
- Zeyu Li
- Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Xiaolong Zhang
- Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Lifei Tian
- Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Zheng Liu
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinhua Liao
- Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Jian Qiu
- Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Guorong Wang
- Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Likun Yan
- Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Xiaoqiang Wang
- Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Xishan Wang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ruiting Liu
- Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| |
Collapse
|
|
4
|
Zhu K, Hu Q, Sun Y. Case report: Laparoscopic-assisted distal gastrectomy for gastric cancer in a patient with situs inversus totalis. Front Surg 2023; 10:1090910. [PMID: 37025267 PMCID: PMC10070824 DOI: 10.3389/fsurg.2023.1090910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 02/24/2023] [Indexed: 04/08/2023] Open
Abstract
Background Situs inversus totalis (SIT) is a rare congenital disease with a series of clinical features characterized by a mirror image distribution of the viscera to the normal anatomy. Case presentation This study aims to report a 63-year-old male SIT patient with gastric cancer with a preoperative diagnosis of stage IIB gastric cancer (cT3N0M0), who underwent a preoperative multi-disciplinary treatment (MDT) discussion and an abdominal enhancement CT for visceral evaluation to ensure a successful operation. A laparoscopic-assisted distal gastrectomy including D2 lymph node dissection and Billroth I reconstruction was successfully performed. Laparoscopic radical gastric gastrectomy and D2 lymph node dissection were performed through the opposite surgical station to the conventional one, followed by digestive tract reconstruction under small incision-assisted direct vision. There was less blood loss throughout the operation, no postoperative complications, and the patient was discharged successfully 10 days after surgery. Histopathological examination showed ulcerated high-medium differentiated adenocarcinoma stage IB (PT2N0M0). There were no complications or tumor recurrence in the patient with examination 6 months after the operation. Conclusion Surgery in a patient with gastric cancer and SIT can be safely performed by the application of 3D laparoscopy and small incisions to assist the digestive tract reconstruction under direct vision.
Collapse
Affiliation(s)
- Kaifeng Zhu
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiang Hu
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
- Correspondence: Qiang Hu
| | - Yuanshui Sun
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| |
Collapse
|
|
5
|
Laparoscopic vs. Robotic Gastrectomy in Patients with Situs Inversus Totalis: A Systematic Review. Minim Invasive Surg 2023; 2023:3894561. [PMID: 36909819 PMCID: PMC9998161 DOI: 10.1155/2023/3894561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 09/16/2022] [Accepted: 02/04/2023] [Indexed: 03/06/2023] Open
Abstract
Background Situs inversus totalis (SIT) is a rare genetic anomaly involving the mirror-image transposition of organs. This transposition can potentially make surgical treatments difficult because of the reversed anatomy and intraoperative confusion. The aim of this systematic review is to compare the perioperative outcomes and safety of robotic and laparoscopic gastrectomy in patients with SIT. Methods We included full-text case reports with brief reviews and standalone case studies on SIT patients age ≥21, undergoing laparoscopic or robotic gastrectomy. We excluded case studies focusing on procedures other than laparoscopic and robotic gastrectomy, namely, open gastrectomy, gastric banding, and gastric bypass. English was selected as the language and articles published in the last 10 years were selected with a date range from Jan, 2011, to Aug, 2021. We focused on intraoperative and postoperative outcomes including blood loss, vascular aberrancy, operation duration, mortality, operative complications, duration of hospitalization, and follow-up interval. Online databases included Clinical Key, Embase, ScienceDirect, Ovid, and Google Scholar. The last search was conducted on Aug 15, 2021. For all eligible articles, risk of bias assessment was carried out using JBI critical appraisal checklist (Table 1). Continuous data were analyzed using t-test with p value of 0.05. Results From our search, we retained 29 case reports which reported information from 30 cases. The results reported in each study were summarized (Table 2). The laparoscopic procedure was used in 21 cases and robot-assisted surgery was used in 9 cases. Operative time was mentioned in 24 out of the 30 cases and the average operative time was 205.67 min. Blood loss was reported in 16 out of the 30 cases, with an average blood loss of 51.9 mL. Hospital stay information was provided in 26 out of the 30 cases, with an average length of stay of 8.5 days. A statistically significant difference was not found for the operative time, length of hospitalization, or age of the patient. However, intraoperative blood loss in robot-assisted gastrectomy was lower compared to laparoscopic gastrectomy, with a p value of 0.0293. Perioperative death was not reported in any of the cases. Only three cases of postoperative complications were reported in laparoscopic surgery. Only one of the three cases suggested that the complication was due to an anomaly, whereas the other two of them reported complications due to procedural errors. Conclusion Laparoscopic and robotic gastrectomy can be safely used for SIT patients if performed cautiously. Some precautions include thoroughly assessing anatomical aberrations using preoperative imaging, adjusting the operative set up, and having experienced surgeons. The robotic approach may have a few advantages over laparoscopic procedures that may enhance the surgical safety for SIT patients and need to be further explored in future research. Advantages of the robotic approach may include improved surgical safety with better visualization of the surgical field, promoting the stability of surgical instruments and perhaps allowing ease of surgical orientation and positioning when operating on patients with SIT. Further research in this field is merited.
Collapse
|
|
6
|
Li BB, Lu SL, He X, Lei B, Yao JN, Feng SC, Yu SP. Da Vinci robot-assisted pancreato-duodenectomy in a patient with situs inversus totalis: A case report and review of literature. World J Gastrointest Oncol 2022; 14:1363-1371. [PMID: 36051094 PMCID: PMC9305577 DOI: 10.4251/wjgo.v14.i7.1363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/30/2022] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Situs inversus totalis (SIT) is an extremely rare congenital malformation characterized by mirror displacement of the thoracoabdominal organs such as the heart, liver, spleen, and stomach. Herein, we describe a patient with SIT complicated with cholangiocarcinoma who underwent successful pancreaticoduodenectomy with the assistance of a da Vinci robot.
CASE SUMMARY A 58-year-old female presented to the hospital with paroxysmal pain in her left upper abdomen, accompanied by jaundice and staining of the sclera as chief complaints. Imaging examination detected a mass at the distal end of the common bile duct, with inverted thoracic and abdominal organs. Endoscopic retrograde cholangiopancreatography forceps biopsy revealed the presence of a well-differentiated adenocarcinoma. The patient successfully underwent robotic-assisted pancreaticoduodenectomy; the operation lasted 300 min, the intraoperative blood loss was 500 mL, and there were no intraoperative and postoperative complications.
CONCLUSION SIT is not directly related to the formation of cholangiocarcinoma. Detailed preoperative imaging examination is conducive to disease diagnosis and also convenient for determining the feasibility of tumor resection. Robot-assisted pancreaticoduodenectomy for SIT complicated with cholangiocarcinoma provides a safe, feasible, minimally invasive, and complication-free alternative with adequate preoperative planning combined with meticulous intraoperative procedures.
Collapse
Affiliation(s)
- Bai-Bei Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Shi-Liu Lu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Xiang He
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Biao Lei
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Jian-Ni Yao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Si-Chen Feng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Shui-Ping Yu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| |
Collapse
|
|
7
|
Elkoussy AMM, Taha AMI, Hassan RA, Nazeh KW. Pancreaticoduodenectomy for pancreatic adenocarcinoma in a patient with situs inversus abdomenalis, a case report. Int J Surg Case Rep 2022; 95:107220. [PMID: 35617735 PMCID: PMC9133586 DOI: 10.1016/j.ijscr.2022.107220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/13/2022] [Accepted: 05/15/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ahmed M M Elkoussy
- HPB Surgery and Liver Transplantation Unit, Surgery Department, Al-Rajhi University Liver Hospital, Assiut University, Egypt.
| | - Ahmed M I Taha
- HPB Surgery and Liver Transplantation Unit, Surgery Department, Al-Rajhi University Liver Hospital, Assiut University, Egypt.
| | - Ramy A Hassan
- HPB Surgery and Liver Transplantation Unit, Surgery Department, Al-Rajhi University Liver Hospital, Assiut University, Egypt.
| | - Kirollos W Nazeh
- Radiology Department, Assiut University Hospital, Assiut University, Egypt
| |
Collapse
|
|
8
|
Robotic distal gastrectomy for gastric cancer in a patient with situs inversus totalis and a vascular anomaly. Int Cancer Conf J 2022; 11:253-260. [DOI: 10.1007/s13691-022-00554-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/09/2022] [Indexed: 11/27/2022] Open
|
|
9
|
Abbey E, Yang F, Qi L, Wu JJ, Tong L, Zhen Z. Situs inversus totalis patients with gastric cancer: Robotic surgery the standard of treatment?-A case report. Int J Surg Case Rep 2021; 81:105818. [PMID: 33887833 PMCID: PMC8050025 DOI: 10.1016/j.ijscr.2021.105818] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/21/2021] [Accepted: 03/21/2021] [Indexed: 12/27/2022] Open
Abstract
Situs inversus totalis is a very rare congenital anomaly. Variant anatomy will inevitably conflict with surgical habits. Minimally invasive surgery for situs inversus totalis patients has more advantages over traditional surgery. Introduction and importance Situs inversus totalis (SIT) is a very rare congenital condition. Situs inversus totalis (SIT) patients who present with gastric cancer have been reported in Japan, China, the United States, and other countries. China has a high incidence of gastric cancer, accounting for 40% of the global annual incidence. Surgical treatment options for situs inversus totalis (SIT) gastric cancer patients are of great concern due to the rare nature of the condition and the anatomical variations. This case aims to demonstrate the utility of robotic surgery in treating situs inversus totalis patients with gastric cancer. Case presentation We report a 69-year-old male situs inversus totalis (SIT) gastric cancer patient who successfully underwent a DaVinci robotic-assisted distal gastrectomy with Roux-en-Y reconstruction. The patient had no complications after the operation and was discharged postoperative day 15. Clinical discussion Gastric cancer is an aggressive disease that requires timely diagnosis and appropriate intervention. Unfortunately, many patients present late with gastric cancer and do not benefit from surgical or other appropriate interventions. Patients who are eligible for surgery however still need a clean marginal resection to maximize prognosis, which is not always possible due to complex anatomy or variations as seen in situs inversus totalis. DaVinci robotic surgery system is a new generation of minimally invasive operating systems after conventional laparoscopy, and its visual field clarity, operating flexibility, and instrument stability have obvious advantages over conventional laparoscopic surgery and traditional open surgery. Conclusion Robotic surgery for situs inversus totalis (SIT) patients is more advantageous than laparoscopic and traditional surgeries as it offers a broader view of the variant anatomy and allows optimum dexterity and clarity.
Collapse
Affiliation(s)
- Eugene Abbey
- First Affiliated Hospital of Zhengzhou University, 450000 Jianshe Street, Erqi District, Zhengzhou, Henan, China; Gastrointestinal Surgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Fu Yang
- First Affiliated Hospital of Zhengzhou University, 450000 Jianshe Street, Erqi District, Zhengzhou, Henan, China; Gastrointestinal Surgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Liu Qi
- First Affiliated Hospital of Zhengzhou University, 450000 Jianshe Street, Erqi District, Zhengzhou, Henan, China; Gastrointestinal Surgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jiang Jian Wu
- First Affiliated Hospital of Zhengzhou University, 450000 Jianshe Street, Erqi District, Zhengzhou, Henan, China; Gastrointestinal Surgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Li Tong
- First Affiliated Hospital of Zhengzhou University, 450000 Jianshe Street, Erqi District, Zhengzhou, Henan, China; Gastrointestinal Surgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhang Zhen
- First Affiliated Hospital of Zhengzhou University, 450000 Jianshe Street, Erqi District, Zhengzhou, Henan, China; Gastrointestinal Surgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
|
10
|
Jian W, Huanqiu C, Chao Y. Utilizing circulating free DNA in diagnosing early gastric cancer in a patient with situs inversus totalis: A case report and literature review. PRECISION MEDICAL SCIENCES 2021. [DOI: 10.1002/prm2.12037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Wang Jian
- Department of General Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Chen Huanqiu
- Department of General Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| | - Yue Chao
- Department of General Surgery Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University Nanjing China
| |
Collapse
|
|
11
|
Munshi FI, Polotti CF, Elsamra SE. Robot-Assisted Radical Cystectomy with Intracorporeal Ileal Conduit in a Patient with Situs Inversus Totalis. J Endourol Case Rep 2020; 6:135-138. [PMID: 33102709 DOI: 10.1089/cren.2019.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Situs invesus totalis is a rare congenital anomaly characterized by the mirror-image transposition of abdominal and thoracic organs. Although feasible, operating on patients with situs inversus offers unique technical challenges to the surgeon because of its rarity and the contralateral disposition of the viscera. Urologists in particular need to be aware of the genitourinary abnormalities associated with situs inversus when planning to operate. Case Presentation: We report the case of a 67-year-old man with invasive bladder cancer in the presence of situs inversus totalis (SIT) and associated bilateral duplicated ureters. This is only the second case of bladder cancer in the context of situs inversus reported in the literature and the first one managed with robot-assisted radical cystectomy and urinary diversion with an intracorporeal ileal conduit. Conclusion: In this unique case, robot-assisted radical cystectomy with intracorporeal ileal conduit in a patient with muscle-invasive bladder cancer and SIT was safely performed and we suggest to others to consider our technique of "mirror-image port placement and surgical technique" if they encounter such a patient.
Collapse
Affiliation(s)
- Faizanahmed I Munshi
- Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Charles F Polotti
- Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Sammy E Elsamra
- Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| |
Collapse
|
|
12
|
A case report of management of gastric perforation in situs inversus totalis in a 45-year-old adult. A case report. Int J Surg Case Rep 2020; 74:69-72. [PMID: 32799055 PMCID: PMC7452593 DOI: 10.1016/j.ijscr.2020.07.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 11/23/2022] Open
Abstract
We report the very first case Management of gastric perforation in situs inversus totalis in a 45-year-old adult. The symptoms of acute peritoneal syndrome have evolved about 48 h. The thoraco-abdomino-pelvic scan confirmed the diagnosis of gastric perforation and situs inversus totalis. The patient underwent laparotomy (suture of gasturic perforation, appendicectomy) with uneventful postoperative course. Introduction Situs inversus is a rare congenital malformation often discovered during childhood. It can cause diagnosis errors in adulthood. Its association with gastric perforation is an extremely rare event in the literature. Its diagnosis is made by an adequate morphological assessment. Presentation of case A 45-years-old man, was admitted to the surgical emergency department for generalized acute abdominal pain initially sitting in the right hypochondrium, accompanied by bilious vomiting and a stop in intestinal transit, progressing for 48 h. He had no known surgical history. The clinical examination noted an altered general state (WHO III) and a peritoneal syndrome. A diagnosis of generalized acute peritonitis has been made. An x-ray of the abdomen without preparation revealed a bilateral pneumoperitoneum with a cardiac point on the right. The thoraco-abdomino-pelvic CT scan confirmed the diagnosis. After resuscitation, the patient underwent a laparotomy with gastroraphy and appendectomy. The postoperative follow-ups were without an uneventful, over a 15-month follow-up. Discussion Situs inversus totalis is an uncomon event. Its exact etiology is still unknown. Some authors incriminate an autosomal recessive gene. In our context, its diagnosis is a surprise. Its revelation by gastric perforation is an extremely rare event. Surgical treatment must be performed early. Prognosis is generally better. Conclusion In developing countries the diagnosis of situs inversus is a surprise during a pathology which led the patient to a medical consultation. CT-scan is one of the key paraclinic exams for its diagnosis.
Collapse
|
|
13
|
Namikawa T, Tsuda S, Fujisawa K, Iwabu J, Uemura S, Tsujii S, Maeda H, Kitagawa H, Kobayashi M, Hanazaki K. Superficial Spreading-type Gastric Cancer with Situs Inversus Totalis. ACTA ACUST UNITED AC 2018; 32:685-689. [PMID: 29695579 DOI: 10.21873/invivo.11294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/10/2018] [Accepted: 03/14/2018] [Indexed: 02/08/2023]
Abstract
Situs inversus totalis (SIT) is a congenital anomaly characterized by a complete mirror-image transposition of the thoracic and abdominal viscera. We report on a rare case of superficial spreading gastric cancer associated with SIT in a 66-year-old woman referred to our hospital for examination of gastric cancer initially diagnosed by medical check-up. Esophagogastroduodenoscopy showed a slightly depressed lesion in the lesser curvature side of the stomach. Abdominal contrast-enhanced computed tomography showed complete transposition of the abdominal viscera, confirming SIT. The patient underwent total gastrectomy with regional lymph node dissection and Roux-en-Y reconstruction. Gross examination of the surgically resected specimen showed a slightly depressed lesion measuring 12×8 cm in diameter, and histopathology confirmed the diagnosis of signet-ring cell carcinoma, confined to the gastric mucosal layer without lymph node metastasis. The postoperative course was favorable, and the patient has been well without evidence of recurrence for 11 years following the operation. To the best of our knowledge, this is only the second case of a superficial spreading-type gastric cancer in a patient with SIT reported in the English literature.
Collapse
Affiliation(s)
| | - Sachi Tsuda
- Department of Surgery, Kochi Medical School, Kochi, Japan
| | | | - Jun Iwabu
- Department of Surgery, Kochi Medical School, Kochi, Japan
| | - Sunao Uemura
- Department of Surgery, Kochi Medical School, Kochi, Japan
| | | | - Hiromichi Maeda
- Cancer Treatment Center, Kochi Medical School Hospital, Kochi, Japan
| | | | - Michiya Kobayashi
- Cancer Treatment Center, Kochi Medical School Hospital, Kochi, Japan.,Department of Human Health and Medical Sciences, Kochi Medical School, Kochi, Japan
| | | |
Collapse
|
|
14
|
Miyaoka Y, Suemitsu S, Fujiwara A, Kotani S, Tsukano K, Yamanouchi S, Kusunoki R, Miyake T, Fujishiro H, Kohge N, Yamamoto T, Amano Y. Endoscopic submucosal dissection of early gastric cancer via inverted overtube in a patient with situs inversus totalis: a case report. Endosc Int Open 2018; 6:E625-E629. [PMID: 29756022 PMCID: PMC5943690 DOI: 10.1055/a-0581-7101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/17/2018] [Indexed: 12/11/2022] Open
Abstract
Background and study aims A 72-year-old man with complete situs inversus presented with early gastric cancer on the lesser curvature wall of the antrum of the stomach. Endoscopic submucosal dissection (ESD) was selected as a treatment. When the patient was positioned in the left decubitus position, the lesion was hidden by blood and gastric fluid because it was located on the gravitational side. Therefore, we decided to perform ESD with the patient in the right lateral decubitus position and use an inverted overtube, which provided a good endoscopic view without the need to rearrange the endoscopist, assistants, or endoscopic system. ESD was safe and feasible using the inverted overtube.
Collapse
Affiliation(s)
- Youichi Miyaoka
- Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan,Corresponding author Youichi Miyaoka, MD, PhD Division of EndoscopyShimane Prefectural Central Hospital4-1-1 Himebara, Izumo 693-8555Shimane, Japan+81-0853-21-2197
| | - Shinsuke Suemitsu
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Aya Fujiwara
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Satoshi Kotani
- Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Kosuke Tsukano
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Satoshi Yamanouchi
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Ryusaku Kusunoki
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Tatsuya Miyake
- Division of Liver, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Hirofumi Fujishiro
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Naruaki Kohge
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Tomohiko Yamamoto
- Division of Pathology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Yuji Amano
- Division of Endoscopy, Kaken Hospital, International University of Health and Welfare, Chiba, Japan
| |
Collapse
|
|
15
|
Aisu Y, Kadokawa Y, Kato S, Yasukawa D, Kimura Y, Hori T. Robot-assisted distal gastrectomy with lymph node dissection for gastric cancer in a patient with situs inversus partialis: a case report with video file. Surg Case Rep 2018; 4:16. [PMID: 29441475 PMCID: PMC5811421 DOI: 10.1186/s40792-018-0422-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/30/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Situs inversus is a rare congenital condition that is currently classified into two types: complete situs inversus (situs inversus totalis, SIT) and partial situs inversus (situs inversus partialis, SIP). In SIP patients, some organs are inverted and others are in their expected position, and individual patient variation in organ position increases surgical difficulty. Several surgeons have performed laparoscopic or robotic surgeries in situs inversus patients, but almost all were SIT patients. We report the first case, to our knowledge, of an SIP patient with gastric cancer who was successfully treated by robot-assisted distal gastrectomy (RADG) with lymph node dissection. CASE PRESENTATION A 64-year-old woman diagnosed with early gastric cancer on the posterior midbody of the stomach was referred to our hospital for treatment. Computed tomography showed levocardia and inverted abdominal organs without enlarged lymph nodes or distant metastases. Polysplenia syndrome, intestinal malrotation, and left-sided gallbladder were also detected. RADG with D1+ lymph node dissection and Billroth I reconstruction (delta-shaped anastomosis) were performed using robotics. Hepatopathy caused by a liver retractor and pancreatic fistula were identified during the postoperative course, and the latter was classified as grade II based on Clavien-Dindo classification. The patient was discharged 18 days after the operation. CONCLUSIONS Preoperative three-dimensional imaging is beneficial, and anatomical organ identification should be routinely performed, especially in SIP patients. We consider RADG a therapeutic option in SIP patients.
Collapse
Affiliation(s)
- Yuki Aisu
- Department of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo Hospital, 200 Mishima-cho, Tenri City, Nara Prefecture 632-8552 Japan
| | - Yoshio Kadokawa
- Department of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo Hospital, 200 Mishima-cho, Tenri City, Nara Prefecture 632-8552 Japan
| | - Shigeru Kato
- Department of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo Hospital, 200 Mishima-cho, Tenri City, Nara Prefecture 632-8552 Japan
| | - Daiki Yasukawa
- Department of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo Hospital, 200 Mishima-cho, Tenri City, Nara Prefecture 632-8552 Japan
| | - Yusuke Kimura
- Department of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo Hospital, 200 Mishima-cho, Tenri City, Nara Prefecture 632-8552 Japan
| | - Tomohide Hori
- Department of Gastrointestinal Surgery, Tenri Yorozu Sōdanjo Hospital, 200 Mishima-cho, Tenri City, Nara Prefecture 632-8552 Japan
| |
Collapse
|
|
16
|
Cao Y, Li J, Shen L, Wang J, Xia Z, Tao K, Wang G, Cai K. Gastric cancer in a situs inversus totalis patient with multiple intestinal and vessel variations related to gastrectomy surgery: A case report and literature review. Medicine (Baltimore) 2017; 96:e8209. [PMID: 28953685 PMCID: PMC5626328 DOI: 10.1097/md.0000000000008209] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Situs inversus totalis (SIT) is a rare congenital anomaly characterized by complete inversion of the abdominal and thoracic organs, and often involves multiple genetic mutations. The most suitable surgical technique for patients with multiple vessel and organ variations as well as SIT remains unclear. Furthermore, there has been insufficient clinical evidence that demonstrates which surgical techniques achieve the best outcomes. Finally, the standard of care has not yet been determined. We present the case of a 60-year-old man with SIT, who was diagnosed with moderately and poorly differentiated adenocarcinoma at the gastroesophageal junction. We further describe the advantage of using robotic-assisted laparoscopic surgery in patients with this anomaly. PATIENT CONCERNS A 60-year-old man complained of pain in his upper abdomen for 3 months. Physical examination revealed an apex beat in the right fifth intercostal space, and vascular anomalies were noted on abdominal angiographic computed tomography. DIAGNOSES Moderately and poorly differentiated adenocarcinoma at the gastroesophageal junction with SIT. INTERVENTIONS Robot-assisted total gastrectomy with D2 lymph node dissection and hand-sewn Roux-en-Y anastomosis was performed. OUTCOMES The postoperative course was uneventful, and the patient was discharged on the seventh postoperative day. LESSONS Robotic surgery for gastric cancer is a safe and feasible alternative to laparoscopic surgery and it can be successfully used to treat gastric cancer in patients with SIT with multiple anatomic variations. As exemplified by our case, SIT might be accompanied by multiple anatomic variations. Detailed preoperative detailed imaging of the blood vessels and gastrointestinal tract is useful in these patients.
Collapse
|