Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2015; 21(35): 10246-10250
Published online Sep 21, 2015. doi: 10.3748/wjg.v21.i35.10246
Laparoscopy-assisted distal gastrectomy for advanced gastric cancer with situs inversus totalis: A case report
Min-Feng Ye, Feng Tao, Guan-Gen Xu, Ai-Jing Sun
Min-Feng Ye, Feng Tao, Guan-Gen Xu, Department of Gastrointestinal Surgery, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, Zhejiang Province, China
Ai-Jing Sun, Department of Pathology, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, Zhejiang Province, China
Author contributions: Ye MF, Tao F and Xu GG performed the surgery; Sun AJ provided the pathological diagnosis; and Ye MF wrote the manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the Shaoxing People’s Hospital.
Informed consent statement: The study participant provided written informed consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: 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/
Correspondence to: Min-Feng Ye, MD, Department of Gastrointestinal Surgery, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, No. 568 Zhongxing North Road, Shaoxing 312000, Zhejiang Province, China. yemphon@aliyun.com
Telephone: +86-575-88229452 Fax: +86-575-85138402
Received: March 16, 2015
Peer-review started: March 16, 2015
First decision: April 13, 2015
Revised: April 27, 2015
Accepted: July 15, 2015
Article in press: July 15, 2015
Published online: September 21, 2015
Abstract

Situs inversus totalis (SIT) is a rare anomaly in which the abdominal and thoracic cavity structures are located opposite to their usual positions. Occasionally, patients with this condition are diagnosed with malignant tumors. We report a case of a 60-year-old woman with gastric cancer and SIT. Laparoscopy-assisted distal gastrectomy (LADG) with D2 lymph node dissection and Billroth II anastomosis were performed successfully on the patient by careful consideration of the mirror-image anatomy. The operation required 230 min, and no intraoperative complications occurred. The final pathological report was pT4aN0M0, according to the American Joint Committee on Cancer 7th edition staging guidelines. The postoperative course was favorable, and the patient was discharged on postoperative day 8. We believe that this is the first case of LADG with D2 lymphadenectomy reported in a SIT patient with advanced gastric cancer.

Keywords: Situs inversus totalis, Laparoscopy-assisted gastrectomy, Gastric cancer, Lymph node dissection, Laparoscopic surgery

Core tip: Laparoscopic surgery in situs inversus totalis patients with gastric cancer is very rare. We performed laparoscopy-assisted distal gastrectomy with D2 lymph node dissection and Billroth II anastomosis successfully in such a patient. We hope to share the experience of laparoscopic gastrectomy in a situs inversus totalis patient with this case report.