DRIVING ON THE OTHER SIDE OF THE ROAD: ANTERIOR RESECTION IN A CASE OF LEFT ISOMERISM

Murtaza Dadla; Arka Banerjee; Sandeep Sangale; Anand Dugad; Rajeev M. Joshi

Volume : VII, Issue : VIII, August - 2018

DRIVING ON THE OTHER SIDE OF THE ROAD: ANTERIOR RESECTION IN A CASE OF LEFT ISOMERISM

Murtaza Dadla, Arka Banerjee, Sandeep Sangale, Anand Dugad, Rajeev M. Joshi

Abstract :

Situs ambiguous or heterotaxy syndrome is a reversal of the usual left and right distribution of the thoracic and abdominal organs which does not entirely correspond to the complete mirror image. Unlike popular belief, situs abnormalities do not represent premalignant conditions and the incidence of malignancies in these patients is almost the same as in patients with situssolitus. A surgical patient with visceral situsinversus forces an operator to abandon the existing operating standards and demands increased watchfulness while performing the procedure. We describe a patient with left isomerism who underwent anterior resection for rectal carcinoma. The altered anatomy made the surgery difficult, especially with a laparascopic approach. Careful consideration of the mirrored anatomy permitted a safe operation using techniques not otherwise differing from those used routinely. Curative surgery for colon cancer, whether laparoscopic or open and in the presence of situsinversus, is challenging, but safe and feasible.