Ye Min-Feng, Tao Feng, Xu Guan-Gen, Sun Ai-Jing
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.
World J Gastroenterol. 2015 Sep 21;21(35):10246-50. doi: 10.3748/wjg.v21.i35.10246.
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 7(th) 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.
全内脏反位（SIT）是一种罕见的异常情况，其中腹腔和胸腔结构位于与其正常位置相反的位置。偶尔，患有这种情况的患者会被诊断出患有恶性肿瘤。我们报告一例60岁患有胃癌和全内脏反位的女性病例。通过仔细考虑镜像解剖结构，成功地对该患者实施了腹腔镜辅助远端胃切除术（LADG），并进行了D2淋巴结清扫和毕罗Ⅱ式吻合术。手术耗时230分钟，未发生术中并发症。根据美国癌症联合委员会第7版分期指南，最终病理报告为pT4aN0M0。术后过程顺利，患者于术后第8天出院。我们认为这是首例报道的对患有进展期胃癌的全内脏反位患者实施LADG并进行D2淋巴结清扫术的病例。
