title: Thoracoscopic esophagectomy for esophageal cancer with situs inversus totalis: a case report and literature review.
abstract: A 63-year-old male visited our hospital, complaining of discomfort when swallowing. Upper gastrointestinal endoscopy revealed a type 2 tumor in the middle thoracic esophagus, which was diagnosed as squamous cell carcinoma by endoscopic biopsy. Computed tomography revealed situs inversus totalis (SIT). We assessed the relationship of the esophagus with neighboring organs using preoperative three-dimensional imaging. We performed thoracoscopic esophagectomy with radical lymph node dissection in the right decubitus position and hand-assisted laparoscopic gastric mobilization in the supine position. The definitive diagnosis was squamous cell carcinoma, pT2N1M0, pStage IIB according to the Union for International Cancer Control. The patient's postoperative course was uneventful, and 5 years post-operation, he is alive without recurrence. In SIT patients, surgical procedures are difficult because of anatomic transposition. Three-dimensional imaging effectively assesses the anatomical structure and contributes to safer thoracoscopic esophagectomy for esophageal cancer patients with SIT. Relevant literature is also discussed and reviewed.
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Ujiie
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. torun@med.tohoku.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kamei
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ichikawa
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Miyata
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Onodera
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohuchi
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012857:Situs Inversus / Q000150:complications* / Q000000981:diagnostic imaging; D013906:Thoracoscopy / Q000379:methods; D014057:Tomography, X-Ray Computed
keywords: Esophageal cancer; Situs inversus totalis; Thoracoscopic esophagectomy; Three-dimensional imaging