title: Laparoscopic distal gastrectomy in a patient with situs inversus totalis: a case report.
abstract: We report our experience with two cases of situs inversus totalis, both involving patients diagnosed with gastric cancer. These were a 52-year-old male with a preoperative staging of cT1bN0M0 and a 68-year-old male with a staging of cT2N0M0, both of whom underwent surgery. The former was found to have vascular anomalies in the preoperative computed tomography, so we performed a computed tomography angiography with three-dimensional reconstruction. Laparoscopy-assisted distal gastrectomy with Billroth I anastomosis was performed with D1+ lymph node dissection, and a small laparotomy was made for extracorporeal anastomosis. In contrast, the latter case showed no vascular anomalies in the preoperative computed tomography, and totally laparoscopic distal gastrectomy with delta anastomosis was performed with D1+ lymph node dissection. There were no intraoperative problems in either patient and they were discharged without postoperative complications. Histopathological examination revealed a poorly differentiated adenocarcinoma (pT2N0M0) and a well-differentiated adenocarcinoma (pT1aN0M0), respectively.
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: Sa-Hong
authors: SH
authors: Min
authors: Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Chang-Min
authors: CM
authors: Lee
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: Heon-Jin
authors: HJ
authors: Jung
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: Kyung-Goo
authors: KG
authors: Lee
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors: Yun-Suhk
authors: YS
authors: Suh
authors: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors: Chung-Il
authors: CI
authors: Shin
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. ; Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Hyung-Ho
authors: HH
authors: Kim
authors: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Han-Kwang
authors: HK
authors: Yang
keywords: Gastric cancer; Laparoscopic-assisted gastrectomy; Lymph node dissection; Situs inversus totalis