Current management of esophageal leiomyoma

Lee, Lawrence S.; Singhal, Sunil; Brinster, Clayton J.; Marshall, Blair; Kochman, Michael L.; Kaiser, Larry R.; Kucharczuk, John C.

doi:10.1016/j.jamcollsurg.2003.08.015

Cited by 130 publications

(184 citation statements)

References 41 publications

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“…Other less common symptoms are dyspepsia, vague retrosternal discomfort, regurgitations and, nearly exceptional, gastrointestinal bleeding secondary to erosion through the mucosa or weight loss caused by dysphagia (7). Even though there are series that find significant relationship between tumor size and symptomatology, we have not found that relationship (3,4).…”

Section: Discussioncontrasting

confidence: 90%

“…Although other clinical entities such as epiphrenic diverticula or gastroesophageal reflux can appear at the same time, it stands by its frequency the simultaneous presence of hiatal hernia, which appears in our series in 38.46% of the cases, slightly higher than other published series, with frequencies from 4.5 to 23% (3,15).…”

Section: Discussioncontrasting

confidence: 61%

“…Incidence is variable, fluctuating from 0.005 to 5.1%, based on different necropsy series (2,3). They are more often found in men, usually between 20 to 50 years old, and are usually located in the lower two-thirds of the esophagus (4).…”

Section: Introductionmentioning

confidence: 99%

“…Most of them are asymptomatic and, when symptoms appear, the most common are dysphagia, heartburn and retrosternal pain (3,4).…”

Section: Introductionmentioning

confidence: 99%

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Comparative study between open and minimally invasive approach in the surgical management of esophageal leiomyoma

et al. 2015

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Introduction: Leiomyomas are the most common benign tumors of the esophagus. Although classically surgical enucleation through thoracotomy or laparotomy has been widely accepted as treatment of choice, development of endoscopic and minimally invasive procedures has completely changed the surgical management of these tumors. Material and methods:We performed a retrospective review of all esophageal leiomyoma operated at Hospital Universitario Ramón y Cajal (Madrid, Spain) between January 1986 and December 2014, analyzing patients' demographic data, symptomatology, tumor size and location, diagnostic tests, surgical data, complications and postoperative stay.Results: Thirteen patients were found within that period, 8 men and 5 women, with a mean age of 53.62 years (range 35-70 years). Surgical enucleation was achieved in all patients. In 8 cases (61.54%) a thoracic approach was performed (4 thoracotomies and 4 thoracoscopies), and in 5 cases (38.56%) an abdominal approach was performed (3 laparotomies and 2 laparoscopies); enucleation was carried out through a minimally invasive approach in 6 patients (46.15%). There were no cases of endoscopic resection alone. Surgery mean length was 174.38 minutes (range 70-270 minutes) and median postoperative stay was 6.5 days (range 2-27 days). There was neither mortality nor cases of intraoperative complications were described. No postoperative major complications were reported; however one patient presented important pain in his right hemithorax that required management and long term follow-up by the Pain Management Unit. With a mean follow-up of 165.57 months (median 170; range 29-336 months) no recurrences were reported.Conclusion: Enucleation is the treatment of choice for the majority of esophageal leiomyomas. In our experience, duration of the surgical procedure through minimally invasive approach was longer than surgery through open approach; however, postoperative stay was shorter in the first group. Paradoxically, incision pain after surgery (thoracic neuralgia) was found to be higher in the minimally invasive approach group. Nevertheless, none of the results obtained in the study reached statistical significance, probably due to the small simple size.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussioncontrasting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

“…Most of them are asymptomatic and, when symptoms appear, the most common are dysphagia, heartburn and retrosternal pain (3,4).…”

Section: Introductionmentioning

confidence: 99%

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Comparative study between open and minimally invasive approach in the surgical management of esophageal leiomyoma

et al. 2015

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“…An enucleation is an adequate procedure due to the benign nature of the tumor. Esophagectomy is rarely indicated, mostly in very large tumors or in the case of severe damage to the esophageal wall during the dissecation [14].In summary, this unique and undescribed case demonstrates leiomyoma of the middle third of the esophagus presenting with an esophago-gastric junction outflow obstruction pattern according to Chicago classification with the diagnosis confirmed by a combination of imaging modalities and high resolution manometry. The pathophysiology of a manometric pattern of esophago-gastric junction outflow obstruction has yet to be determined.…”

Section: Discussionmentioning

confidence: 80%

Esophageal Leiomyoma with Esophagogastric Junction Outflow Obstruction at High Resolution Manometry

Marano¹,

Petrillo²,

Grassia³

et al. 2014

Int J Gastroenterol Disord Ther

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Esophageal leiomyoma represents 60-80% of all benign esophageal neoplasms and rarely has been reported associated with disorder of esophageal motor activity. We discussed here a unique case of patient with leiomyoma of the middle third of the esophagus associated with esophagogastric junction outflow obstruction pattern at high resolution manometry. Thoracoscopic enucleationof a leiomyoma of the esophagus is recommended and the optimal approaches should be tailored based on the location and size of the tumor. Nevertheless the pathophysiology of manometric pattern of esophago-gastric junction outflow obstruction associated with this benign neoplasm has yet to be determined.

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Tumors of the Esophagus

Smith

Lightdale

2021

The Esophagus

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Current management of esophageal leiomyoma

Cited by 130 publications

References 41 publications

Comparative study between open and minimally invasive approach in the surgical management of esophageal leiomyoma

Comparative study between open and minimally invasive approach in the surgical management of esophageal leiomyoma

Esophageal Leiomyoma with Esophagogastric Junction Outflow Obstruction at High Resolution Manometry

Tumors of the Esophagus

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