全内脏反位合并胃癌、胃肠道间质瘤一例并文献复习

Situs inversus totalis complicated with gastric cancer and gastrointestinal stromal tumor:a case report and review of the literature

目的回顾一例全内脏反位合并胃癌、胃肠道间质瘤病例的诊治经过,探讨内脏反位合并胃癌手术的安全性。方法收集2020年12月中国人民解放军空军特色医学中心收治的1例全内脏反位合并胃癌、胃肠道间质瘤患者的诊疗资料,检索国内外内脏反位合并胃癌的文献报道,分析患者的临床诊断及手术情况。结果该例患者在全身麻醉下行剖腹探查、胃癌根治术(毕Ⅱ、结肠前、顺蠕动+布朗氏吻合),手术过程顺利,手术时间180 min,出血量100 mL,术后无并发症。结论全内脏反位合并胃癌患者手术与常规胃癌手术方式相同,在完善术前评估后,选择合理术式是安全可行的。

Objective To review the diagnosis and treatment process for a case of situs inversus totalis complicated with gastric cancer and gastrointestinal stromal tumor and to analyze the safety of surgery for situs inversus totalis complicated with gastric cancer.Methods The diagnosis and treatment data of a patient with situs inversus totalis complicated with gastric cancer and gastrointestinal stromal tumor who was admitted to Air Force Medical Center,PLA in December 2020 were collected.The domestic and foreign literature reports on situs inversus totalis complicated with gastric cancer were searched,and the clinical diagnosis and treatment data and surgical situation of the patients in the reported literature were analyzed.Results The patient underwent exploratory laparotomy and radical gastrectomy for gastric cancer(BillrothⅡ,precolonic,peristalsis in sequence+Brown′s anastomosis)under general anesthesia.The surgical process was smooth,with a surgical duration of 180 minutes and a bleeding volume of 100 mL.There were no postoperative complications.Conclusion The surgical approach for a patient with situs inversus totalis complicated with gastric cancer is not different from the conventional surgical approach of gastric cancer.After completing preoperative evaluation,selecting a reasonable surgical approach is safe and feasible.