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      Gastric cancer with situs inversus totalis: does it really create difficulties for surgeons?

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          Abstract

          Introduction

          Situs inversus totalis (SIT) is a very rare condition that is seen at a rate of one in about 6000–8000 births.

          Aim

          To offer a general view on the coexistence of SIT and gastric cancer, accompanied by a literature review.

          Material and methods

          Within the scope of this study, the case of a patient with gastric adenocarcinoma and SIT has been presented. Previous research on gastric cancer cases with SIT was reviewed through a comprehensive search of the PubMed, Medline, and Google Scholar databases. The keywords used to conduct this research were “situs inversus totalis and gastric cancer,” “situs inversus totalis and gastric malignant,” and “situs inversus totalis and gastric resection.” The database search covered English studies published between 2000 and 2016.

          Results

          The results of our literature review revealed 20 studies of patients with gastric cancer and SIT, and 21 related cases. Overall, 12 of the patients were male, 9 were female, and their mean age was 61.8 ±10.97 years. The vascular assessment data showed that three out of the 13 mentioned cases had vascular anomalies. Eleven of the patients had laparoscopic resections, and one of the patients that had a surgical procedure exhibiting a postoperative mechanical obstruction.

          Conclusions

          The coexistence of SIT and gastric cancer is a very rare condition, and a careful preoperative radiological assessment should be conducted because there can be accompanying vascular anomalies. Laparoscopies and robotic surgeries can be performed for suitable patients at experienced centres, consistent with oncological principles.

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          Most cited references29

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          Surgery in Situs Inversus.

          H Blegen (1949)
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            Advanced cancer with situs inversus totalis associated with KIF3 complex deficiency: report of two cases.

            Situs inversus totalis (SIT) is a relatively rare congenital anomaly, occurring at an incidence of 1 in 10 000-50 000 live births. Although there are some case reports of SIT with the presence of cancer, there are few reports on the relationship between SIT and cancer. However, the recent phylogenetic investigations of this condition suggest that this may be linked to the development and progression of cancer on the molecular level. The key elements are one of the intracellular motor proteins, the KIF3 complex, and the cell-adhesion factors N-cadherin and beta-catenin. We herein present the cases of advanced gastric cancer and lung cancer with SIT, and review the relationship between SIT and the development and progression of cancer.
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              Laparoscope-assisted distal gastrectomy for early gastric cancer in a 76-year-old man with situs inversus totalis.

              We report a case of a 76-year-old man with situs inversus totalis (SIT) who developed early gastric cancer. He was successfully treated by laparoscope-assisted distal gastrectomy for the gastric cancer. This case suggests that patients with SIT with malignancy could also undergo laparoscopic surgery. To the best of our knowledge, no case of laparoscopic surgery for malignant neoplasms associated with SIT has been reported in the English literature. We therefore believe this is the first case report.
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                Author and article information

                Journal
                Prz Gastroenterol
                Prz Gastroenterol
                PG
                Przegla̜d Gastroenterologiczny
                Termedia Publishing House
                1895-5770
                1897-4317
                26 March 2018
                2018
                : 13
                : 1
                : 47-51
                Affiliations
                Gastroenterological Surgery Department, Kartal Koşuyolu High Speciality and Training Hospital, Istanbul, Turkey
                Author notes
                Address for correspondence: Ebubekir Gündeş MD, Gastroenterological Surgery Department, Kartal Koşuyolu High Speciality and Training Hospital, Denizer cad. No: 22, 34000 Istanbul, Turkey. phone: +90 5058606740. e-mail: ebubekir82@ 123456hotmail.com
                Article
                32323
                10.5114/pg.2018.74563
                5894452
                29657611
                012a4b1d-3726-4c4e-bba5-c9baed6354e1
                Copyright: © 2018 Termedia Sp. z o. o.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                : 16 April 2017
                : 01 June 2017
                Categories
                Original Paper

                situs inversus totalis,gastric cancer,gastrectomy
                situs inversus totalis, gastric cancer, gastrectomy

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