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      Laparoscopy-assisted resection of colorectal cancer with situs inversus totalis: A case report and literature review

      case-report

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          Abstract

          BACKGROUND

          Situs inversus totalis (SIT) is a rare anomaly in which structures are located opposite to their usual positions. It is not a premalignant condition and the association with colorectal cancer (CRC) is rare. We here report a patient with SIT who underwent laparoscopic radical resection of sigmoid colon cancer, and review the pertinent literature.

          CASE SUMMARY

          A 53-year-old woman presented with CRC and SIT and underwent a complete examination after admission. The patient then underwent laparoscopic radical resection of sigmoid colon cancer and hyperthermic intraperitoneal chemotherapy. The operation duration was 120 min, and no intraoperative complications occurred. The final pathological report showed stage T4aN0M0. Postoperative chemotherapy was administered and no evidence of recurrence was observed during 18 mo of follow-up.

          CONCLUSION

          Surgery in a patient with CRC and SIT can be safely performed on the basis of routine preoperative clinical examination.

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          Most cited references19

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          Laparoscopic cholecystectomy in situs inversus totalis: The importance of being left-handed.

          C L Ronchera-Oms, J Badia (2003)
          Since laparoscopic cholecystectomy has become the standard procedure for the treatment of gallstone disease, several cases have been reported in patients with situs inversus. These cases require more technically demanding procedures due to the symmetrical disposition of the anatomy. Thus, handedness could influence the performance of these operations. The two of us (L.M.O.) and (J.M.B.), a right-handed and a left-handed surgeon, respectively, placed the instruments in reverse mode from that used in orthotopic patients. The right-handed surgeon felt more impairment when dissecting with his left hand and decided to cross the instruments within the abdomen. The left-handed surgeon was able to alternate the performance of the dissection maneuvers between the right and left hands. Surgical procedures are apparently designed for right-handed surgeons and can be approached by the left-handed in alternative ways. In fact, the accommodation of laparoscopic cholecystectomy to left-handedness has been described in the literature. The rare opportunity to operate in a symmetrical way allows the right-handed surgeon to understand the absence of comfort and ergonomy often experienced by left-handed colleagues.
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            Advanced cancer with situs inversus totalis associated with KIF3 complex deficiency: report of two cases.

            Tomohiro Haruki, S Miyasaka, Takashi Sawata … (2009)
            Situs inversus totalis (SIT) is a relatively rare congenital anomaly, occurring at an incidence of 1 in 10 000-50 000 live births. Although there are some case reports of SIT with the presence of cancer, there are few reports on the relationship between SIT and cancer. However, the recent phylogenetic investigations of this condition suggest that this may be linked to the development and progression of cancer on the molecular level. The key elements are one of the intracellular motor proteins, the KIF3 complex, and the cell-adhesion factors N-cadherin and beta-catenin. We herein present the cases of advanced gastric cancer and lung cancer with SIT, and review the relationship between SIT and the development and progression of cancer.
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              Laparoscopic hemicolectomy in a patient with situs inversus totalis.

              Masayuki Higashino, S Tanimura, Yushi Fujiwara … (2007)
              As among persons with normal anatomy, occasional patients with situs inversus develop malignant tumors. Recently, several laparoscopic operations have been reported in patients with situs inversus. We describe laparoscopic hemicolectomy with radical lymphadenectomy in such a patient. Careful consideration of the mirror-image anatomy permitted safe operation using techniques not otherwise differing from those in ordinary cases. Thus, curative laparoscopic surgery for colon cancer in the presence of situs inversus is feasible and safe.
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                Author and article information

                Contributors
                Wei Chen
                Jing-Lin Liang
                Jun-Wen Ye
                Yan-Xin Luo
                Mei-Jin Huang
                Journal
                Journal ID (nlm-ta): World J Gastrointest Endosc
                Journal ID (publisher-id): WJGE
                Title: World Journal of Gastrointestinal Endoscopy
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 1948-5190
                Publication date (Print): 16 September 2020
                Publication date (Electronic): 16 September 2020
                Volume: 12
                Issue: 9
                Pages: 310-316
                Affiliations
                Department of Colorectal Surgery, The Six Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
                Department of Colorectal Surgery, The Six Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
                Department of Colorectal Surgery, The Six Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
                Department of Colorectal Surgery, The Six Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
                Department of Colorectal Surgery, The Six Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China. 13924073322@ 123456139.com
                Author notes

                Author contributions: Chen W, Liang JL, Ye JW, Luo YX, and Huang MJ contributed to the study design, data collection, analysis, and interpretation, drafting of the final manuscript, and supervision; all authors approved the final version of the manuscript.

                Corresponding author: Mei-Jin Huang, PhD, Academic Fellow, Doctor, Department of Colorectal Surgery, The Six Affiliated Hospital, Sun Yat-sen University, No. 26 Yuancun Erheng Road, Tianhe District, Guangzhou 510655, Guangdong Province, China. 13924073322@ 123456139.com

                Article
                Other ID: jWJGE.v12.i9.pg310
                DOI: 10.4253/wjge.v12.i9.310
                PMC ID: 7503618
                SO-VID: f7cda6db-62bf-45e5-8f28-fed5dc3dd40f
                Copyright © ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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.

                History
                Date received : 9 April 2020
                Date revision received : 9 July 2020
                Date accepted : 4 August 2020
                Categories
                Subject: Case Report

                Keywords: colorectal cancer,situs inversus totalis,hyperthermic intraperitoneal chemotherapy,case report
                Data availability:
                Keywords: colorectal cancer, situs inversus totalis, hyperthermic intraperitoneal chemotherapy, case report

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