Zheng ZL, Zhang SR, Sun H, Tang MC, Shang JK. Laparoscopic radical resection for situs inversus totalis with colonic splenic flexure carcinoma: A case report. World J Clin Cases 2022; 10(16): 5435-5440 [PMID: 35812688 DOI: 10.12998/wjcc.v10.i16.5435]
Corresponding Author of This Article
Shou-Ru Zhang, Doctor, PhD, Associate Chief Physician, Department of Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing 400030, China. zsrhjp@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zi-Ling Zheng, Shou-Ru Zhang, Hao Sun, Mao-Cai Tang, Jing-Kun Shang, Department of Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing 400030, China
Author contributions: Zheng ZL and Zhang SR performed the surgical method analyses and interpretation, and contributed to manuscript drafting; Tang MC and Shang JK analyzed and interpreted the imaging findings; Zhang SR and Sun H were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported byChongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau), No. 2021MSXM309.
Informed consent statement: The patient's informed consent has been obtained in this case.
Conflict-of-interest statement: The authors have no financial disclosures or conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shou-Ru Zhang, Doctor, PhD, Associate Chief Physician, Department of Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing 400030, China. zsrhjp@126.com
Received: September 27, 2021 Peer-review started: September 27, 2021 First decision: December 10, 2021 Revised: December 22, 2021 Accepted: April 22, 2022 Article in press: April 22, 2022 Published online: June 6, 2022 Processing time: 248 Days and 2.9 Hours
Abstract
BACKGROUND
Situs inversus totalis (SIT) is a rare group of congenital developmental malformations in the clinical setting, with all organs in the chest and abdomen existing in a mirror image reversal of their normal positions. Few reports have described laparoscopic surgery for colorectal cancer in patients with SIT, and it is considered difficult even for an experienced surgeon because of the mirror positioning. We present a case report of laparoscopic radical resection of a colonic splenic flexure carcinoma in a patient with SIT.
CASE SUMMARY
A 72-year-old male was referred to our hospital with colonic splenic flexure carcinoma, and computed tomography showed that all the organs in the chest and abdomen were inverted. Laparoscopic hemicolectomy with complete mesocolic excision was safely performed. The operating surgeon stood on the patient’s left side, which is opposite of the normal location.
CONCLUSION
Abdominal computed tomography is an effective method for diagnosing SIT preoperatively in patients with colonic splenic flexure carcinomas. Laparoscopic radical resection is difficult, but it is well established and safe. The surgeon should stand in the opposite position and perform backhand operations.
Core Tip: The incidence of situs inversus totalis is very low, especially in patients with malignant tumors. Surgical resection is currently the primary treatment option for colon cancer. The safe performance of this surgery requires the use of a comprehensive imaging evaluation before the operation and a highly skilled and cooperative team.
