摘要
BACKGROUND Situs inversus totalis(SIT)is a rare congenital anomaly that refers to a completely reversed location of abdominal and thoracic organs.An extremely small number of patients with this condition,especially those with rectal neoplasms,have been reported.Surgery in these patients is technically challenging.Therefore,we reconstructed a three-dimensional(3D)digital model with the Materialise’s interactive medical image control system(Mimics)as a guide for laparoscopic resection.CASE SUMMARY We report the case of a 68-year-old woman with rectal neoplasms and SIT diagnosed by electronic colonoscopy biopsy and enhanced computed tomography(CT),which showed that there was a soft tissue mass protruding into the lumen in the lower rectal segment,a lesion that involved the serosal layer,multiple enlarged peripheral lymph nodes,and visceral situs abnormalities.Based on the CT images,we reconstructed a 3D model with Mimics to assist with our surgical planning.Then,we performed laparoscopyassisted radical resection of the rectal neoplasms and total excision of the lesion.Adjuvant chemotherapy with the XELOX regimen(oxaliplatin 150 mg,D1+Xeloda 1.0 g,Bid,D1-14)was initiated 1 mo after the operation.The patient recovered well after surgery,and her physical condition remained stable.CONCLUSION Preoperative 3D reconstruction of the imaging results could help reduce the unknown risks during surgery caused by anatomical abnormalities and improvethe perioperative safety for patients.
BACKGROUND Situs inversus totalis(SIT) is a rare congenital anomaly that refers to a completely reversed location of abdominal and thoracic organs. An extremely small number of patients with this condition, especially those with rectal neoplasms, have been reported. Surgery in these patients is technically challenging. Therefore, we reconstructed a three-dimensional(3 D) digital model with the Materialise’s interactive medical image control system(Mimics) as a guide for laparoscopic resection.CASE SUMMARY We report the case of a 68-year-old woman with rectal neoplasms and SIT diagnosed by electronic colonoscopy biopsy and enhanced computed tomography(CT), which showed that there was a soft tissue mass protruding into the lumen in the lower rectal segment, a lesion that involved the serosal layer, multiple enlarged peripheral lymph nodes, and visceral situs abnormalities. Based on the CT images, we reconstructed a 3 D model with Mimics to assist with our surgical planning. Then, we performed laparoscopyassisted radical resection of the rectal neoplasms and total excision of the lesion.Adjuvant chemotherapy with the XELOX regimen(oxaliplatin 150 mg, D1 +Xeloda 1.0 g, Bid, D1-14) was initiated 1 mo after the operation. The patient recovered well after surgery, and her physical condition remained stable.CONCLUSION Preoperative 3 D reconstruction of the imaging results could help reduce the unknown risks during surgery caused by anatomical abnormalities and improve the perioperative safety for patients.
基金
Supported by the State’s Key Project of Research and Development Plan,No.2017YFC0108300 and No.2017YFC0108303
