Thoracoscopic enucleation of esophageal leiomyomas: a feasible and safe procedure

In recent years, minimally invasive approaches have been introduced, providing thoracoscopic/laparoscopic techniques in the treatment of esophageal leiomyomas. We determined the technical feasibility and patient safety of thoracoscopic enucleation of esophageal leiomyomas by evaluation of 10 consecutive patients undergoing this procedure. For the surgical approach, a four-trocar access via the right pleural cavity in single-lung ventilation was chosen. All minimally invasive procedures were successfully completed without conversion to open surgery. Every tumor was completely resected without opening of the mucosa. No relevant intra- or postoperative complications were detected. These data suggest that thoracoscopic enucleation is a feasible and safe procedure for esophageal leiomyomas.

References

• 1 Sauerbruch F. Presentations in the field of thoracic surgery.  Arch Klin Chir. 1932;  173 457
• 2 Ohsawa T. Surgery of the oesophagus.  Arch Jpn Chir. 1933;  10 605
• 3 Everitt N J, Glinatsis M, McMahon M J. Thoracoscopic enucleation of leiomyoma of the oesophagus.  Br J Surg. 1992;  79 643
• 4 Gossot D, Fourquier P, el Meteini M, Celerier M. Technical aspects of endoscopic removal of benign tumors of the esophagus.  Surg Endosc. 1993;  7 102-103
• 5 Peracchia A, Fumagalli U, Rosati R. Thoracoscopic techniques in treatment of esophageal diseases.  Chirurg. 1994;  65 671-676
• 6 Bonavina L, Segalin A, Rosati R. et al . Surgical therapy of esophageal leiomyoma.  J Am Coll Surg. 1995;  181 257-262
• 7 Izumi Y, Inoue H, Endo M. Combined endoluminal-intracavitary thoracoscopic enucleation of leiomyoma of the esophagus. A new method.  Surg Endosc. 1996;  10 457-458
• 8 Bardini R, Asolati M. Thoracoscopic resection of benign tumours of the esophagus.  Int Surg. 1997;  82 5-6
• 9 Takemura M, Higashino M, Osugi H. et al . Thoracoscopic enucleation of esophageal leiomyomal.  Nippon Kyobu Geka Gakkai Zasshi. 1997;  45 1606-1611
• 10 Roviaro G C, Maciocco M, Varoli F. et al . Videothoracoscopic treatment of oesophageal leiomyoma.  Thorax. 1998;  53 190-192
• 11 Takada N, Higashino M, Osugi H. et al . Utility of endoscopic ultrasonography in assessing the indications for endoscopic surgery of submucosal esophageal tumors.  Surg Endosc. 1999;  13 228-230
• 12 Pross M, Manger T, Wol S. et al . Thoracoscopic enucleation of benign tumors of the esophagus under simultaneous exible esophagoscopy.  Surg Endosc. 2000;  14 1146-1148
• 13 Coral R P, Madke G, Westphalen A. et al . Thoracoscopic enucleation of a leiomyoma of the upper thoracic esophagus.  Dis Esophagus. 2003;  16 339-341
• 14 Samphire J, Nafteux P, Luketich J. Minimally invasive techniques for resection of benign esophageal tumors.  Semin Thorac Cardiovasc Surg. 2003;  15 35-43
• 15 Von Rahden B H, Stein H J, Feussner H, Siewert J R. Enucleation of submucosal tumors of the esophagus: minimally invasive versus open approach.  Surg Endosc. 2004;  18 924-930
• 16 Elli E, Espat N J, Berger R. et al . Robotic-assisted thoracoscopic resection of esophageal leiomyoma.  Surg Endosc. 2004;  18 713-716
• 17 Zheng R H, Feng M X, Ge D, Hou Y Y. Diagnosis and treatment of esophageal leiomyoma.  Zhonghua Wei Chang Wai Ke Za Zhi. 2005;  8 26-28
• 18 Ousadden A, Bourdariat R, Poncet G, Boulez J. Esophageal leiomyoma. Six cases of video-assisted enucleation.  Presse Med. 2006;  35 1649-1655
• 19 Zaninotto G, Portale G, Costantini M. et al . Minimally invasive enucleation of esophageal leiomyoma.  Surg Endosc. 2006;  20 1904-1908
• 20 Wehrmann T, Martchenko K, Nakamura M. et al . Endoscopic resection of submucosal esophageal tumors: a prospective case series.  Endoscopy. 2004;  36 802-807