Abstract
Situs inversus totalis is an uncommon anatomical congenital anomaly characterized by complete transposition of viscera with right-to-left reversal across the sagittal plane. Consequently, surgery in such cases is more technically challenging and requires a complete reorientation of visual-motor coordination skills. We describe a case of a 50-year-old gentleman with locally advanced lower esophagus carcinoma post-neoadjuvant chemoradiotherapy with situs inversus totalis and treated with minimally invasive McKeown esophagectomy using a left thoracoscopic, laparoscopic-assisted and right cervical approach. The operative procedure and difficulties during surgery are highlighted. Minimal invasive esophagectomy is safe and feasible in situs inversus totalis. Recognition of the anatomy with a meticulous preoperative planning is advocated for an uneventful operative intervention.
References
Mayo CW, Rice RG (1949) Situs inversus totalis: a statistical review of data on seventy-six cases with special reference to disease of the biliary tract. Arch Surg 58:724–730
Niikawa N, Kohsaka S, Mizumoto M, Hamada I, Kajii T (1983) Familial clustering of situs inversus totalis, and asplenia and poly splenia syndromes. Am J Med Genet 16:43–47
Bohun CM, Potts JE, Casey BM, Sandor GG (2007) A population-based study of cardiac malformations and outcomes associated with dextrocardia. Am J Cardiol 100:305–309
Oms LM, Badia JM (2003) Laparoscopic cholecystectomy in situs inversus totalis: the importance of being left-handed. Surg Endosc 17:1859–1861
Yoshida Y, Saku M, Masuda Y, Maekawa S, Ikejiri K, Furuyama M (1992) Total gastrectomy for gastric cancer associated with situs inversus totalis. A report of 2 cases. S Afr J Surg 30:156–158
Yoshida T, Usui S, Inoue H, Kudo SE (2004) The management of esophageal cancer with situs inversus totalis by simultaneous hand-assisted laparoscopic gastric mobilization and thoracoscopic esophagectomy. J Laparoendosc Adv Surg Tech 14(6):384–389
Mimae T, Nozaki I, Kurita A, Takashima S (2008) Esophagectomy via left thoracotomy for esophageal cancer with situs inversus totalis: report of a case. Surg Today 38(11):1044–1047
Aoki Y, Hihara J, Emi M, Sakogawa K, Hamai Y, Okada M (2011) Advanced esophageal cancer with situs inversus totalis successfully treated with chemoradiotherapy followed by esophagectomy: case report. Hiroshima J Med Sci 60(1):21–24
Yagi Y, Yoshimitsu Y, Maeda T, Sakuma H, Watanabe M, Nakai M, Ueda H (2012) Thoracoscopic esophagectomy and hand-assisted laparoscopic gastric mobilization for esophageal cancer with situs inversus totalis. J Gastrointest Surg 16(6):1235–1239
Peel J, Darling G (2014) Left video-assisted thoracoscopic surgery esophagectomy in a patient with situs inversus totalis and Kartagener syndrome. Ann Thorac Surg 98(2):706–708
Chinusamy P, Bansal S, Praveenraj P, Ramakrishnan P (2016) Minimally invasive McKeown esophagectomy with modified three-field lymphadenectomy in case of situs inversus totalis with carcinoma mid esophagus. J Minim Access Surg 12(1):68–70
Singh G, Costa J, Bessler M, Sonett J (2016) Minimally invasive Ivor Lewis oesophago-gastrectomy in a patient with situs inversus totalis. Interact Cardiovasc Thorac Surg 22(2):235–237
Ujiie N, Nakano T, Kamei T, Ichikawa H, Miyata G, Onodera K, Ohuchi N (2016) Thoracoscopic esophagectomy for esophageal cancer with situs inversus totalis: a case report and literature review. Gen Thorac Cardiovasc Surg 64(6):359–362
Ramanandham B (2016) Transhiatal oesophagectomy for a patient with carcinoma oesophagus and situs inversus totalis—a unique case report. Univ J Surg Surg Spec 19:2(3)
Nakano T, Kamei T, Onodera Y, Ujiie N, Ohuchi N (2017) Thoracoscopic surgery in the prone position for esophageal cancer in patients with situs inversus totalis: a report of two cases. Int J Surg Case Rep 31:43–46
Charalabopoulos A, Kordzadeh A, Sdralis E, Lorenzi B, Ahmad F (2019) Thoracoscopic total esophagogastrectomy with supercharged colon interposition for the treatment of esophageal adenocarcinoma in situs inversus. Acta Chir Belg 119(4):259–262
Biere SS, Maas KW, Bonavina L, Garcia JR, van Berge Henegouwen MI, Rosman C, Sosef MN, De Lange ES, Bonjer HJ, Cuesta MA, Van Der Peet DL (2011) Traditional invasive vs. minimally invasive esophagectomy: a multi-center, randomized trial (TIME-trial). BMC Surg 11(1):2
Straatman J, Van Der Wielen N, Cuesta MA, Daams F, Garcia JR, Bonavina L, Rosman C, van Berge Henegouwen MI, Gisbertz SS, Van Der Peet DL (2017) Minimally invasive versus open esophageal resection: three-year follow-up of the previously reported randomized controlled trial the TIME trial. Ann Surg 266(2):232–236
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Nusrath, S., Murtaza Ahmed, S., Madhunarayana, B. et al. Operative Challenges with Minimally Invasive McKeown Esophagostomy with Two-Field Lymphadenectomy in a Case of Situs Inversus Totalis with Carcinoma Esophagus: A Case Report with Review of the Literature. Indian J Surg Oncol 11, 662–667 (2020). https://doi.org/10.1007/s13193-020-01132-4
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DOI: https://doi.org/10.1007/s13193-020-01132-4