A Case of Sigmoid Colon Cancer with Complete Situs Inversus Treated by Laparoscopic Sigmoidectomy

Abstract

An 84-year-old female with known complete situs inversus from childhood presented at our hospital with fecal occult blood positivity. A colonoscopy revealed a type 2 lesion at the sigmoid-descending colon junction. Abdominal computed tomography confirmed the presence of complete situs inversus and revealed wall thickening of the sigmoid colon. Rule blood vessel of sigmoid colon cancer was sigmoid artery 1st branch by 3D Computed tomography. As the diagnosis was sigmoid colon cancer in a patient with complete situs inversus, we performed a laparoscopic sigmoidectomy with the operator, assistants, nurse, operation instruments, and monitors placed in positions opposite to those used for a standard laparoscopic sigmoidectomy. The presence of adhesions increased the operative time, but the patient’s postoperative progress was good and no complications occurred. A literature search revealed 26 case reports describing laparoscopic operations for colon cancer in patients with complete situs inversus. All the operations were safely performed without excessive extension of the operative time or the occurrence of postoperative complications.