Skip to main content

Esophagectomy via left thoracotomy for esophageal cancer with situs inversus totalis: Report of a case

Surgery Today volume 38, pages 1044–1047 (2008)Cite this article

Abstract

We report a case of successful esophagectomy via a left thoracotomy for esophageal cancer in a 57-year-old Japanese man with situs inversus totalis. An upper gastrointestinal endoscopy, performed to investigate the cause of dysphagia, revealed a 7-cm irregular shaped mass occupying more than half of the circumference of the middle-third of the esophagus. Computed tomography (CT) showed enlarged mediastinal lymph nodes and situs inversus totalis. Histological examination of a biopsy specimen revealed squamous cell carcinoma of the esophagus. Although esophagectomy is usually performed through a right thoracotomy because of the left position of the aortic arch, we performed successful subtotal esophagectomy with radical lymph node dissection through a left thoracotomy. During surgery, we modifi ed the standard surgical technique in a mirrorimage fashion to complete the esophagectomy safely. The patient had an uneventful postoperative course.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Okuyama M, Motoyama S, Suzuki H, Saito R, Maruyama K, Ogawa J. Hand-sewn cervical anastomosis versus stapled intrathoracic anastomosis after esophagectomy for middle or lower thoracic esophageal cancer: a prospective randomized controlled study. Surg Today 2007;37:947–952.

    PubMed  Article  Google Scholar 

  2. Doki Y, Yasuda T, Miyata H, Fujiwara Y, Takiguchi S, Yamasaki M, et al. Salvage lymphadenectomy of the right recurrent nerve node with tracheal involvement after definitive chemoradiation therapy for esophageal squamous cell carcinoma: report of two cases. Surg Today 2007;37:590–595.

    PubMed  Article  Google Scholar 

  3. Edwards JE. Anomalies of the aortic arch system. Birth Defects 1977;13:47–63.

    PubMed  CAS  Google Scholar 

  4. Kocis KC, Midgley FM, Ruckman RN. Aortic arch complex anomalies: 20-year experience with symptoms, diagnosis, associated cardiac defects, and surgical repair. Pediatr Cardiol 1997;18:127–132.

    PubMed  Article  CAS  Google Scholar 

  5. Yoshida T, Usui S, Inoue H, Kudo S. The management of esophageal cancer with situs inversus totalis by simultaneous hand-assisted laparoscopic gastric mobilization and thoracoscopic esophagectomy. Laparoendosc Adv Surg Tech A 2004;14(6):384–389.

    Google Scholar 

  6. Guillen P, Fontaine C, Triboulet JP. Esophageal carcinoma resection and right aortic arch: successful approach through left thoracotomy. Dis Esophagus 1999;12:212–215.

    Article  Google Scholar 

  7. Shimakawa T, Naritaka Y, Wagatuma Y, Konno S, Katsube T, Ogawa K. Esophageal cancer associated with right aortic arch: a case study. Anticancer Res 2006;26:3733–3738.

    PubMed  Google Scholar 

  8. Noguchi H, Naomoto Y, Haisa M, Yamatsuji T, Shigemitsu K, Ohkawa T, et al. Esophageal cancer associated with right aortic arch: Report of two cases. Dis Esophagus 2003;16:332–334.

    PubMed  Article  CAS  Google Scholar 

  9. Park SS, Min BW, Kim WB, Han HJ, Yong HS, Kim SJ, et al. Double cancer of the stomach and oesophagus with situs ambiguous with polysplenia: the importance of preoperative evaluation. Dig Liver Dis 2005;37:799–802.

    PubMed  Article  Google Scholar 

  10. Schmutzer PV. Situs inversus totalis associated with complex cardiovascular anomalies. Am Heart J 1958;56:761.

    PubMed  Article  CAS  Google Scholar 

  11. Glew D, Hartnell GG. The right aortic arch revisited. Clin Radiol 1991;43:305–307.

    PubMed  Article  CAS  Google Scholar 

  12. Hastreiter AR, D’Cruz IA, Cantez T, Namin EP, Licata R. Part I: right sided aorta. Occurrence of right aortic arch in various types of congenital heart disease. Part II: right aortic arch, right descending aorta and associated anomalies. Br Heart J 1966;28:722–739.

    PubMed  Article  CAS  Google Scholar 

  13. Stewart JR, Kincaid OW, Titus JL. Right aortic arch: plain film diagnosis and signifi cance. Am J Roentgenol 1991;97:377–389.

    Google Scholar 

  14. Merklin RJ, Varano NR. Situs inversus and cadiac defects — a study of 111 cases of reversed asymmetry. J Thoracic Cardiovasc Surg 1963;45:334–342.

    CAS  Google Scholar 

  15. Knight L, Edwards JE. Right aortic arch; types and associated cardiac anomalies. Circulation 1974;50:1047–1051.

    PubMed  CAS  Google Scholar 

  16. Backer CL, Ilbawi MN, De Idriss FS, Leon SY. Vascular anomalies causing tracheoesophageal compression: review of experience in children. J Thorac Cardiovasc Surg 1989;97:725–731.

    PubMed  CAS  Google Scholar 

  17. Yano M, Shiozaki H, Murata A, Inoue M, Tamura S. Successful resection of thoracic esophageal carcinoma associated with the right aortic arch. Surg Today 1998;28:76–78.

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Surgery, Shikoku Cancer Center, 160 Kou Minami-Umenomoto, Matsuyama, 791-0280, Japan

    Takahiro Mimae, Isao Nozaki, Akira Kurita & Shigemitsu Takashima

Authors
  1. Takahiro Mimae
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Isao Nozaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akira Kurita
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shigemitsu Takashima
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Mimae, T., Nozaki, I., Kurita, A. et al. Esophagectomy via left thoracotomy for esophageal cancer with situs inversus totalis: Report of a case. Surg Today 38, 1044–1047 (2008). https://doi.org/10.1007/s00595-008-3770-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-008-3770-2

Key words

  • Situs inversus totalis
  • Esophageal cancer
  • Left thoracotomy