Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5435
Peer-review started: September 27, 2021
First decision: December 10, 2021
Revised: December 22, 2021
Accepted: April 22, 2022
Article in press: April 22, 2022
Published online: June 6, 2022
Processing time: 248 Days and 2.9 Hours
Situs inversus totalis (SIT) is a rare group of congenital developmental malformations in the clinical setting, with all organs in the chest and abdomen existing in a mirror image reversal of their normal positions. Few reports have described laparoscopic surgery for colorectal cancer in patients with SIT, and it is considered difficult even for an experienced surgeon because of the mirror positioning. We present a case report of laparoscopic radical resection of a colonic splenic flexure carcinoma in a patient with SIT.
A 72-year-old male was referred to our hospital with colonic splenic flexure carcinoma, and computed tomography showed that all the organs in the chest and abdomen were inverted. Laparoscopic hemicolectomy with complete mesocolic excision was safely performed. The operating surgeon stood on the patient’s left side, which is opposite of the normal location.
Abdominal computed tomography is an effective method for diagnosing SIT preoperatively in patients with colonic splenic flexure carcinomas. Laparoscopic radical resection is difficult, but it is well established and safe. The surgeon should stand in the opposite position and perform backhand operations.
Core Tip: The incidence of situs inversus totalis is very low, especially in patients with malignant tumors. Surgical resection is currently the primary treatment option for colon cancer. The safe performance of this surgery requires the use of a comprehensive imaging evaluation before the operation and a highly skilled and cooperative team.