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Laparoscopy‐assisted distal gastrectomy in a case of gastric cancer with situs inversus totalis: a case report
Author(s) -
Kigasawa Yu,
Takeuchi Hiroya,
Kawakubo Hirofumi,
Fukuda Kazumasa,
Nakamura Rieko,
Takahashi Tsunehiro,
Wada Norihito,
Kitagawa Yuko
Publication year - 2017
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12326
Subject(s) - medicine , situs inversus , surgery , laparoscopy , dissection (medical) , gastrectomy , lymph node , cancer , adenocarcinoma , stage (stratigraphy) , paleontology , biology
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.