Giant leiomyoma of esophagus

Kramer, Marshall D.; Gibb, S. Peter; Ellis, F. Henry

doi:10.1002/jso.2930330304

Cited by 23 publications

(16 citation statements)

References 6 publications

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“…Over the years, minimally invasive surgery has caused a major paradigm shift from conventional open abdominal surgery. The excellent outcomes achieved in general surgery have been similarly demonstrated in thoracic surgery, with notable improvement in length of hospital stay, patient discomfort, and rapid return to preoperative activity . While thoracoscopic and laparoscopic enucleation of esophageal leiomyomas and other benign esophageal tumors is certainly a safe and effective operation, potential limitations to these techniques may be encountered.…”

Section: Discussionmentioning

confidence: 92%

Robotic‐assisted enucleation of a large lower esophageal leiomyoma and review of literature

Khalaileh

Savetsky

Adileh

et al. 2013

Robotics Computer Surgery

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Leiomyoma is the most common benign esophageal neoplasm. Different invasive surgical approaches have been described for management of such lesions. The literature is reviewed and a robotic assisted left thoracoscopic enucleation with the patient in the right side position is described. A 40-year-old male patient, otherwise healthy, found to have a lower midiastinal mass on screening X-ray, is described. Physical examination and blood tests were within normal limits. Diagnostic work-up included: computerized tomography (CT) scanning of the chest and midiastinum that revealed a 40 × 30 mm mass of the distal esophagus, an upper gastrointestinal endoscopy showed a lower protruding esophageal submucosal mass with intact mucosa, a filling defect was apparent on esophagography. Endoscopic ultrasonography (EUS) showed the same findings, biopsies were taken and leimyoma was diagnosed. Under general anesthesia with a double-lumen endotracheal tube, the patient was positioned on his right side. A 30 robotic scope was introduced in the left 7th intercostal space on the posterior axillary line. Two 8-mm robotic trocars were inserted in the left 5th and 9th intercostals spaces on the same line. Operative field was clearly exposed and an additional 5-mm ethicon trocar was inserted. The inferior pulmonary ligament was released, the parietal pleural space opened, proximal and distal control was achieved using Penrose. The muscular layer of the lower esophagus was opened by coagulation hook, the lesion was enucleated without mucosal penetration. Intraoperative endoscopy permitted localization of the lesion and ensured mucosal integrity. The muscular layer was not closed and the chest drain was left. Total operative time was 200 min and blood loss was less than 20 mL. A Gastrograffin swallow on the first post-operative day showed good esophageal clearance and absence of leak, the patient was allowed a liquid diet. He was discharged on the third post-operative day in a good general condition, benign pathology was confirmed.

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Section: Discussionmentioning

confidence: 92%

Robotic‐assisted enucleation of a large lower esophageal leiomyoma and review of literature

Khalaileh

Savetsky

Adileh

et al. 2013

Robotics Computer Surgery

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“…The resection site can be covered by pedicled pleural, omental, or muscular flaps [14][15][16][17]. Esophageal resection is advocated when the leiomyomas are large in size (>8 cm) or show a circular growth pattern [1,18], if the tumor is densely adhesive to the mucosa, or if extensive mucosal damage occurs accidentally during enucleation [11]. Leiomyoma are called "giant" when their size exceeds 10 cm [14].…”

Section: Discussionmentioning

confidence: 99%

“…There was no mortality in this series, although severe complications such as anastomotic leakage, chylothorax, and intrathoracic infection occurred. Colonic interposition was also performed in a giant esophageal leiomyoma measuring 20.5 cm and weighing 540 g [18], after an esophago-pleural fistula resulted from a biopsy. In the scope of increasing expectations upon minimal invasive surgery, Boone et al [21] recently reported on a successful robot-assisted thoracoscopic esophagectomy with the formation of a gastric conduit via laparotomy and a hand-sewn cervical anastomosis in a patient with a large 9×5×2.5-cmmeasuring leiomyoma.…”

Section: Discussionmentioning

confidence: 99%

Esophageal resection for giant leiomyoma: report of two cases and a review of the literature

Rijcken

Kersting²,

Senninger

et al. 2008

Langenbecks Arch Surg

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“…Studies have reported the incidence in the range of 0.005% to 7.9%. [1][2][3] The true incidence of esophageal leiomyoma, however, is debatable because many small lesions are asymptomatic and may not be diagnosed at the time of autopsy. The peak age of occurrence is between 30 and 59, and is rare in children.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of the esophageal leiomyoma: lessons from a retrospective review

Choi

Kim

Han

et al. 2010

Diseases of the Esophagus

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Esophageal leiomyoma is the most common benign tumor of the esophagus. Although enucleation via thoracotomy has been considered standard treatment, minimally invasive surgery is increasingly used for the treatment of this disease. We analyzed our surgical outcomes by comparing thoracotomy and the thoracoscopic approach. A retrospective review was performed of patients who underwent surgical resection of esophageal leiomyomas at the Seoul National University Hospital. Between 1982 and 2005, 63 patients were identified (male, n= 39; female, n= 24) at a mean age of 44.5 years. Thirty-two patients (51%) were symptomatic. Forty-five patients underwent thoracotomy, and 18 patients were resected using thoracoscopy. There was no mortality. The mean length of hospital stay was 10.3 days in the open group and 8.0 days in thoracoscopy group. Intraoperative mucosal repair was required in eight patients. Preoperative endoscopic mucosal biopsy within 1 month was identified as a risk factor for mucosal injury. Among the 11 patients with tumors less than 1.5 cm in size, thoracoscopic resection was attempted on four patients, and three out of the four cases required conversions to thoracotomy. Minimally invasive surgery for esophageal leiomyoma can be performed with good results. Our results suggest that the thoracoscopic approach should be considered as a standard surgical method for the treatment of esophageal leiomyoma. However, in cases of small tumors less than 1.5 cm in size, localization of the tumor may be difficult, and if asymptomatic, a regular monitoring should be considered as an alternative approach in such small tumors.

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Giant leiomyoma of esophagus

Cited by 23 publications

References 6 publications

Robotic‐assisted enucleation of a large lower esophageal leiomyoma and review of literature

Robotic‐assisted enucleation of a large lower esophageal leiomyoma and review of literature

Esophageal resection for giant leiomyoma: report of two cases and a review of the literature

Surgical management of the esophageal leiomyoma: lessons from a retrospective review

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