Ito Jun, Kaiho Yasuhiro, Iwamura Hiromichi, Anan Go, Sato Makoto
Department of Urology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Asian J Endosc Surg. 2019 Apr;12(2):185-188. doi: 10.1111/ases.12608. Epub 2018 May 23.
Situs inversus totalis (SIT) is a rare congenital anomaly characterized by complete inversion of the thoracic and abdominal organs. Many intra-abdominal and vessel anomalies have been reported in association with SIT. However, there have been no reports on the use of laparoscopic radical nephrectomy with thrombectomy for renal vein thrombus, which is considered as a safe and feasible procedure, in patients with SIT. We herein present the case of an 80-year-old man with SIT who was preoperatively diagnosed with a right renal tumor and renal vein tumor thrombus. The patient underwent laparoscopic right nephrectomy and tumor thrombectomy with no intraoperative complications. To ensure a safe procedure, the anatomy and vessels were carefully evaluated preoperatively using 3-D multiplanar reconstructed CT imaging. Assessing anatomical structures leads to safer laparoscopic radical nephrectomy for renal cell carcinoma with venous tumor thrombus in patients with SIT.
全内脏反位（SIT）是一种罕见的先天性异常，其特征为胸腹部器官完全反转。许多腹内和血管异常已被报道与SIT相关。然而，对于SIT患者，尚无关于采用腹腔镜根治性肾切除术联合血栓切除术治疗肾静脉血栓的报道，而这一手术被认为是安全可行的。我们在此报告一例80岁的SIT男性患者，其术前被诊断为右肾肿瘤及肾静脉肿瘤血栓。该患者接受了腹腔镜右肾切除术及肿瘤血栓切除术，术中无并发症发生。为确保手术安全，术前使用三维多平面重建CT成像仔细评估了解剖结构和血管。评估解剖结构可使SIT患者在患有静脉肿瘤血栓的肾细胞癌时进行更安全的腹腔镜根治性肾切除术。
