Thoracoscopic enucleation of esophageal leiomyoma in prone position and single lumen endotracheal intubation

Claus, Christiano Marlo Paggi; Filho, A. M. Cury; Boscardim, Paulo Cesar Buffara; Andriguetto, P. C.; Loureiro, Marcelo; Bonin, Eduardo A.

doi:10.1007/s00464-013-2918-3

Cited by 12 publications

(6 citation statements)

References 33 publications

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“…Video-assisted thoracoscopic surgery including thoracoscopic enucleation is described as a minimally invasive surgical procedure for esophageal SMT[ 5 ]. Performing thoracoscopic enucleation in the prone position, as compared with thoracotomy or thoracoscopic surgery in the decubitus position, has the advantages of adequate working area, minimal blood loss, and short postoperative stay[ 2 , 3 ]. However, the possibility of thoracoscopic enucleation may be limited by the tumor location and size.…”

Section: Discussionmentioning

confidence: 99%

Combined thoracoscopic and endoscopic surgery for a large esophageal schwannoma

Onodera

Nakano

Takeyama

et al. 2017

WJG

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A 47-year-old woman presented to our hospital with complaints of dysphagia. Esophagogastroduodenoscopy identified a submucosal tumor in the left wall of the esophagus that was diagnosed as a benign schwannoma on biopsy. Computed tomography revealed a tumor of length 60 mm in the thoracic esophagus, with its cranial edge at the level of the aortic arch. On endoscopy, a submucosal tunnel was created 40 mm proximal to the cranial edge of the tumor, and its oral end was dissected from the mucosal and muscular layers. This was followed by the resection of the entire tumor by left-sided thoracoscopy. The esophageal defect was closed in layer by continuous suture from the thoracic side. Endoscopic closure was achieved by using clips. No postoperative complications were observed. Oral diet was resumed from postoperative day 7 and the patient was discharged on postoperative day 9. This combined approach has not been described for similar tumors. Our experience demonstrated that large esophageal tumors can be safely excised with minimally invasive surgery by using a combination of thoracoscopy and endoscopy.

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Section: Discussionmentioning

confidence: 99%

Combined thoracoscopic and endoscopic surgery for a large esophageal schwannoma

Onodera

Nakano

Takeyama

et al. 2017

WJG

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“…Many reports have recently investigated the prone position during minimally invasive esophagectomy for esophageal carcinoma, focusing on how it may contribute to suitable surgical visibility and the reduction of postoperative complications. Claus et al [ 11 ] reported the successful thoracoscopic enucleation of esophageal leiomyoma in the prone position with single-lumen endotracheal intubation in 10 patients, without any conversions [ 11 ]. We have also performed esophagectomy through a right thoracoscopy in the prone position, followed by laparoscopy and left cervicotomy in the supine position to treat upper thoracic esophageal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Thoracoscopic Surgery for Esophageal Submucosal Tumors

Kang

Yun

Kim

et al. 2015

Korean J Thorac Cardiovasc Surg

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BackgroundSurgical enucleation is the treatment of choice for esophageal submucosal tumors (SMTs) with symptomatic, larger, or ill-defined lesions. The enucleation of SMTs has traditionally been performed via thoracotomy. However, minimally invasive approaches have recently been introduced and successfully applied. In this study, we present our experiences with the thoracotomic and thoracoscopic approaches to treating SMTs.MethodsWe retrospectively reviewed 53 patients with SMTs who underwent surgical enucleation between August 1996 and July 2013. Demographic and clinical features, tumor-related factors, the surgical approach, and outcomes were analyzed.ResultsThere were 36 males (67.9%) and 17 females (32.1%); the mean age was 49.2±11.8 years (range, 16 to 79 years). Histology revealed leiomyoma in 51 patients, a gastrointestinal stromal tumor in one patient, and schwannoma in one patient. Eighteen patients (34.0%) were symptomatic. Fourteen patients underwent a planned thoracotomic enucleation. Of the 39 patients for whom a thoracoscopic approach was planned, six patients required conversion to thoracotomy because of overly small tumors or poor visualization in five patients and accidental mucosal injury in one patient. No mortality or major postoperative complications occurred. Compared to thoracotomy, the thoracoscopic approach had a slightly shorter operation time, but this difference was not statistically significant (120.0±45.6 minutes vs. 161.5±71.1 minutes, p=0.08). A significant difference was found in the length of the hospital stay (9.0±3.2 days vs. 16.5±5.4 days, p<0.001).ConclusionThe thoracoscopic enucleation of submucosal esophageal tumors is safe and is associated with a shorter length of hospital stay compared to thoracotomic approaches.

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“…There have been previous reports on thoracoscopic enucleation of esophageal leiomyoma in the prone position [ 10 , 11 , 12 ]. Additionally, we report the present case.…”

Section: Discussionmentioning

confidence: 99%

Prone Position Is Useful in Thoracoscopic Enucleation of Esophageal Leiomyoma

Maki¹,

Takeno²,

Nimura

et al. 2015

Case Rep Gastroenterol

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A 36-year-old man was admitted to our institute due to the diagnosis of esophageal submucosal tumor detected by a periodical upper gastrointestinal endoscopic examination without any complaint. Thoracoscopic enucleation of the lesion with the preoperative clinical diagnosis of esophageal leiomyoma was performed under general anesthesia in the prone position. After immunohistochemical examination, the pathological diagnosis was leiomyoma. There was no remarkable event during the postoperative hospital stay, and the patient was discharged on the 12th day after surgery. This case report suggests that the prone position might be superior to the left lateral decubitus position in thoracoscopic enucleation of esophageal leiomyoma.

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Thoracoscopic enucleation of esophageal leiomyoma in prone position and single lumen endotracheal intubation

Cited by 12 publications

References 33 publications

Combined thoracoscopic and endoscopic surgery for a large esophageal schwannoma

Combined thoracoscopic and endoscopic surgery for a large esophageal schwannoma

Retrospective Analysis of Thoracoscopic Surgery for Esophageal Submucosal Tumors

Prone Position Is Useful in Thoracoscopic Enucleation of Esophageal Leiomyoma

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