Kobe University Graduate School of Medicine - CRSLS

Single-Site Laparoscopic Colectomy in a Patient With Situs Inversus Totalis

SLS — Mon, 10 Jul 2017 14:11:05 +0000

Yasuo Sumi, MD, PhD, Takeru Matsuda, MD, PhD, Kimihiro Yamashita, MD, PhD, Hiroshi Hasegawa, MD, PhD, Taro Oshikiri, MD, PhD, Tetsu Nakamura, MD, PhD, Satoshi Suzuki, MD, PhD, Yoshihiro Kakeji, MD

Division of Minimally Invasive Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan (Dr Sumi).
Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan (Matsuda, Yamashita, Hasagawa, Oshikiri, Nakamura, Suzuki, and Kakeji).

ABSTRACT

Introduction: Situs inversus totalis (SIT) is a rare congenital anomaly in which the abdominal and thoracic cavity structures are located opposite to their usual positions. Occasionally, patients with SIT, who have malignant tumors, are encountered. Recently, several laparoscopic operations have been reported in patients with SIT.

Case Description: We report a case of a 74-year-old woman with SIT who developed cecum cancer. Single-site laparoscopic colectomy (SSLC) with radical lymphadenectomy was successfully performed with careful consideration of the mirror-image anatomy. The techniques themselves were not different from those used in ordinary cases.

Conclusion: Thus, SSLC for colon cancer in a patient with SIT can be performed safely by a skilled surgeon after thorough preoperative planning, including assessment of the anomaly. This procedure therefore remains a feasible option, even for patients with SIT, allowing them to benefit from minimally invasive surgery.

Key Words: Right colon cancer, Single-site laparoscopic surgery, Situs inversus totalis.

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Curable Resection in Gastric and Lymph Node Metastases From Melanoma

SLS — Sat, 15 Nov 2014 20:49:50 +0000

Yasunori Otowa, MD, Satoshi Suzuki, MD, PhD, Tatsuya Imanishi, MD, PhD, Tetsu Nakamura, MD, PhD, Kenichi Tanaka, MD, PhD, Masanobu Sakaguchi, MD, PhD, Toshinori Bito, MD, PhD, Yoshihiro Kakeji, MD, PhDDepartment of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan (Drs. Otowa, Suzuki, Imanishi, Nakamura, Tanaka, and Kakeji).Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan (Drs. Sakaguchi and Bito).

ABSTRACT

We herein report a rare case of gastric and regional lymph node metastasis of cutaneous malignant melanoma that underwent curative resection. The patient, a 68-year-old man, was first diagnosed as having cutaneous malignant melanoma of the right forearm in 2005. He had extensive skin excision and axillary lymph node dissection and had undergone adjuvant chemotherapy. Six years after the primary surgery, gastrointestinal endoscopy revealed gastric metastasis of a malignant melanoma. As there was no other metastasis found, laparoscopic-assisted distal gastrectomy with lymph node dissection was performed. Microscopic findings showed diffuse melanin granule growth invading the muscularis propria of the stomach. Micrometastases of the lymph nodes were observed that were not detected by preoperative examination. Seventeen months have passed without recurrence. We conclude that regional lymph node dissection should be performed with gastrectomy whenever distant metastases are not observed, because there is a possibility of micrometastases, which cannot be detected preoperativ

Key Words: Gastrectomy, Gastric metastasis, Laparoscopic surgery, Lymph node metastasis, Melanoma.

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The post Curable Resection in Gastric and Lymph Node Metastases From Melanoma first appeared on CRSLS.