Published online Sep 21, 2015. doi: 10.3748/wjg.v21.i35.10246
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
Processing time: 185 Days and 17.1 Hours
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.
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.