Fujita Shunsuke, Etoh Tsuyoshi, Kono Yohei, Fujishima Hajime, Suzuki Kosuke, Ninomiya Shigeo, Ueda Yoshitake, Shiroshita Hidefumi, Shiraishi Norio, Inomata Masafumi
Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Oita, 879-5593, Japan.
Department of Advanced Medical Research and Development for Cancer and Hair, Oita University Faculty of Medicine, Oita, Japan.
Surg Case Rep. 2022 Sep 27;8(1):182. doi: 10.1186/s40792-022-01532-4.
Situs inversus totalis (SIT) is a relatively rare condition, in which the thoracic and abdominal organs are reversed or mirrored from their normal positions. Here, we reported a case of a patient with SIT and advanced gastric cancer with lymph node metastasis who underwent laparoscopic distal gastrectomy (LDG).
A 67-year-old man with SIT was clinically diagnosed with T3N2M0 advanced gastric cancer located in the middle gastric body. Three-dimensional reconstruction of computed tomography angiogram revealed that the common hepatic artery originated from the superior mesenteric artery. The patient underwent LDG with D2 lymph node dissection and Roux-en-Y reconstruction. The postoperative course was uneventful.
This case report showed that LDG could be safely performed on a patient even under complex conditions, such as advanced gastric cancer with lymph node metastasis with SIT and vascular anomalies.
全内脏反位（SIT）是一种相对罕见的病症，其中胸腹部器官从其正常位置发生反转或镜像。在此，我们报告了一例患有SIT和伴有淋巴结转移的进展期胃癌患者接受腹腔镜远端胃切除术（LDG）的病例。
一名患有SIT的67岁男性临床诊断为位于胃体中部的T3N2M0进展期胃癌。计算机断层血管造影的三维重建显示肝总动脉起源于肠系膜上动脉。该患者接受了D2淋巴结清扫和Roux-en-Y重建的LDG。术后过程顺利。
本病例报告表明，即使在复杂情况下，如伴有SIT和血管异常的伴有淋巴结转移的进展期胃癌患者，也可以安全地进行LDG。
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