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Abstract
Aims: To report a new approach by combining thoracoscopy and esophagoscopy as a means of guidance to dissect esophageal submucosal tumors in preventing mucosal damage.
Methods: A total of 6 esophageal leiomyoma patients were consecutively operated on from January 2022 to January 2023, of which 5 were men and 1 woman with an average age of 46.66 ± 15.34 (28 - 63).
Results: Five patients had a single leiomyoma and one patient had 2 adjacent leiomyomas. The longest tumor length averaged 3.21 ± 1.76 cm (2.2 - 7.0). All 6 patients underwent right - sided thoracoscopic surgery under esophageal endoscopic supervision. Frozen biopsy showed leiomyoma in all 6 patients. No patient needed conversion to open surgery or thoracoscopic esophagectomy. One patient had a mucosal perforation during surgery that was sutured. The average surgery time is 111.66 minutes ± 24.62 (90 - 180 minutes). No patient died. No patient had pneumonia or esophageal leakage postoperatively. The average postoperative hospital stay was 7.16 ± 3.43 days. In addition, the time of gastric tube placement and chest tube placement were 2.66 days and 1.83 days, respectively.
Conclusion: Combining thoracoscopic and esophageal endoscopic surgery to remove esophageal submucosal myoma is feasible and safe. However, research on a large number of patients is needed to have a more accurate assessment of this method.
References
Xu H, Li Y, Wang F, et al. Video-Assisted Thoracoscopic
Surgery for Esophageal Leiomyoma: A Ten-Year SingleInstitution Experience. J Laparoendosc Adv Surg Tech A.
;28:1105-8.
Seremetis MG, Lyons WS, DeGuzman VC, Peabody JW.
Leiomyomata of the esophagus - an analysis of 838 cases.
Cancer. 1976;38:2166-77.
Mutrie CJ, Donahue DM, Wain JC, et al. Esophageal
leiomyoma. A 40-year experience. Ann Thorac Surg. 2005;
:1122-5.
Luh SP, Hou SM, Fang CC, et al. Video-thoracoscopic
enucleation of esophageal leiomyoma. World J Surg Oncol.
;10:52
Inoue H, Ikeda H, Hosoya T, Onimaru M, Yoshida A,
Eleftheriadis N, Maselli R,Kudo S. Submucosal endoscopic
tumor resection for subepithelial tumors in the esophagus
and cardia. Endoscopy. 2012;44:225-30.
Technology Committee ASGE, Aslanian HR, Sethi A,Bhutani MS, et al. ASGE guideline for endoscopic fullthickness resection and submucosal tunnel endoscopic
resection. Official Video Journal of the American Society
for Gastrointestinal Endoscopy. 2019;4:343-50.
Koki Oyama1, Kenoki Ohuchida1, Koji Shindo et al.,
Thoracoscopic surgery combined with endoscopic creation
of a submucosal tunnel for a large complicated esophageal
leiomyoma. Surgical Case Reports. 2020;6:92.
Inoue H, Ikeda H, Hosoya T, Onimaru M, Yoshida A,
Eleftheriadis N, Maselli R, Kudo S. Submucosal endoscopic
tumor resection for subepithelial tumors in the esophagus
and cardia. Endoscopy. 2012;44:225-30.
Arnorsson T, Aberg C, Aberg T. Benign tumours of the
oesophagus and oesophageal cysts. Scand J Thorac Surg.
;18:145-50.
Akahoshi K, Sumida Y, Matsui N, et al. Preoperative
diagnosis of gastrointestinal stromal tumor by endoscopic
ultrasound guided fine needle aspiration. World J
Gastroenterol. 2007;14:2077-82.
Ando N, Goto H, Niwa Y, et al. The diagnosis of GI
stromal tumors with EUS guided fine needle aspiration
with immunohistochemical diagnosis. Gastrointest Endosc.
;55:37-43.
Watson RR, Binmoeller KF, Hamerski CM, et al. Yield
and performance characteristics of endoscopic ultrasoundguided fine needle aspiration for diagnosing upper GI tract
stromal tumors. Dig Dis Sci. 2011;56:1757-1762.
Dendy M, Johnson K, Boffa DJ. Spectrum of FDG uptake
in large (>10 cm) esophageal leiomyomas. J Thorac Dis.
;7:E648-51.
Depypere L, Coosemans W, Nafteux P. Fluorine-18-
fluorodeoxyglucose uptake in a benign oesophageal
leiomyoma: a potential pitfall in diagnosis. Interact
Cardiovasc Thorac Surg. 2012;14:234-6.
Pih GY, Kim DH. Endoscopic ultrasound-guided fine needle
aspiration and biopsy in gastrointestinal subepithelial
tumors. Clin Endosc. 2019;52:314-20.
Baysal B, Masri OA, Eloubeidi MA, et al. The role of EUS
and EUS-guided FNA in the management of subepithelial
lesions of the esophagus: a large, single-center experience.
Endosc Ultrasound. 2017;6:308-16.
Daiko H, Fujita T, Ohgara T, Yamazaki N, Yano T, et
al. Minimally invasive hybrid surgery combined with
endoscopic and thoracoscopic approaches for submucosal
tumor originating from thoracic esophagus. World Journal
of Surgical Oncology. 2015;13:40.
Liang C, Hussain K, Yuchen S, Zhitao G, Ji C, Fang W.
A novel hybrid approach for enucleation of esophageal
leiomyoma. J Thorac Dis. 2019;11: 2576-80.
Robb WB, Bruyere E, Amielh D, et al. Esophageal
gastrointestinal stromal tumor: is tumoral enucleation a
viable therapeutic option? Ann Surg. 2015; 261:117-24.
Gupta V, Sinha SK, Vaiphei K, Lal A. Esophageal resection
for giant leiomyoma. J Cancer Res Ther. 2015;11:651.
| Published | 28-12-2024 | |
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| Issue | No. 90 (2023) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.90.14 | |
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Copyright (c) 2023 Journal of Clinical Medicine Hue Central Hospital