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Case Reports
. 2021 Jan;12(1):122-127.
doi: 10.1111/1759-7714.13723. Epub 2020 Nov 5.

Total minimally invasive McKeown esophagectomy in an esophageal cancer patient with situs inversus totalis: A case report

Chu-Long Xie  1   2 , Jing-Sheng Cai  1   2 , Zi-Hui Tan  1   2 , Jie Yang  1   2 , Hao-Xian Yang  1   2
Affiliations
Case Reports

Total minimally invasive McKeown esophagectomy in an esophageal cancer patient with situs inversus totalis: A case report

Chu-Long Xie et al. Thorac Cancer. 2021 Jan.

Abstract

Situs inversus totalis (SIT) is an extremely rare anomaly characterized by a left-to-right reversal of all the thoracic and abdominal organs. Only 11 cases of esophageal cancer with SIT have been reported worldwide, most of which underwent hybrid minimally invasive esophagectomy (MIE) but not total MIE. Here, we report a case of esophageal cancer with SIT successfully treated by total MIE, with a right lateral-prone position adopted during the thoracic procedure. The relevant literature is also discussed and reviewed.

Keywords: Esophageal cancer; situs inversus totalis; total minimally invasive esophagectomy.

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Figures

Figure 1
Figure 1
Preoperative imaging examination confirmed the presence of SIT and middle third esophageal cancer. (a) Chest X‐ray showing dextrocardia and a right aortic arch; (b) Barium swallow showing the tumor in the middle third esophagus; Cross section (c) and sagittal section (g) of CT showing the tumor (arrow); Chest CT (d), Abdominal CT (e) and coronal section of CT (f) showing SIT; (h) Endoscopic ultrasound revealed an ulcerated esophageal tumor; Anterior (i) and posterior views (j) of 3‐D images demonstrating the surrounding structures around the esophagus.
Figure 2
Figure 2
Surgical views. (a) Position and ports in thoracoscopic procedure; (b) Surgeon's position during the thoracic procedure; (c) Anatomic structures of the right‐side (c) and left‐side (d) recurrent laryngeal nerve; (e) Position and ports in laparoscopic procedure; (f) Surgeon's position during the laparoscopic procedure. H, head; F, foot.
Figure 3
Figure 3
Postoperative imaging examination and histopathology. (a) Chest X‐ray of postoperative day 1; (b) Barium swallow of postoperative day 16; (c) Gross tumor specimen; (d, e) Moderately differentiated squamous cell carcinoma confirmed by histopathology.
See this image and copyright information in PMC

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