Laparoscopic approach in the treatment of large leiomyoma of the lower third of the esophagus.

Abstract

Leiomyoma of the lower third of the esophagus is a relatively rare disorder but the most common benign tumor of the esophagus. We present a case of an involuted esophageal leiomyoma, 11 cm in size, treated by the laparoscopic approach. The preoperative computed tomogram visualized a mass 3 × 1.5 cm in diameter in the lower esophagus without an eccentric lumen or compression of nearby organs. Resection of the tumor was indicated according to the patient‘s symptoms and to exclude malignancy. Laparoscopic enucleation of esophageal leiomyoma was performed. The overall operative time was 205 min. The diagnosis of leiomyoma was established on histopathology and immunohistochemistry staining. The patient resumed the intake of a normal diet on the 5th postoperative day and was discharged from hospital 8 days after the surgery. We have found this minimally invasive operation to be an effective and well-tolerated treatment option, determined by the experience of the surgeon.

Complete laparoscopic-transhiatal removal of duplex benign oesophageal tumour: case report and review of literature

“…When the operation is combined with intraoperative oesophagoscopy, several advantages are on hand: first, localising the tumour is easier; second, checking the mucous membrane after enucleation can minimize postoperative complications [ 36 ]. If the tumour is located at least 3 cm above the GEJ, GERD (gastroesophageal reflux disease—GERD)-associated symptoms are lacking and the oesophageal wall can be reconstructed successfully; there is therefore no need for semifundoplication [ 37 , 38 ]. Laparoscopic transhiatal enucleation of lower oesophageal leiomyomas and other benign tumours is a safe, fast and effective operation, and offers a good therapeutic alternative to VATS.…”

Missed Giant Lower Esophageal Leiomyoma in a Young Female Presenting with Refractory Gastroesophageal Reflux Disease

“…is is the first time that such a giant leiomyoma is reported in a young woman in Vietnam. ere were several options for the enucleation of such tumors, such as the thoracotomic, thoracoscopic, or laparoscopic approach [9,10]. However, the laparoscopic transhiatal approach was chosen in order to avoid causing extensive defect in the esophageal wall, which might lead to impaired esophageal peristalsis and damage of the lower esophageal sphincter.…”

Giant leiomyoma in distal, intra-thoracic oesophagus: Is laparoscopic approach feasible?

“…1,2,9-13 Differential diagnoses include malignant tumours of the oesophagus, GIST, other benign tumours of the oesophagus, foreign bodies. 10 Sussius was the first to use the phrase benign oesophageal tumour to describe the condition in 1559. The tumour was discovered on autopsy, located in the distal oesophagus, and was cited as a leiomyoma, although histologic confirmation was lacking.…”

“…7,8 Most patients with oesophageal leiomyomas are detected incidentally, however when they attain bigger size, they can cause symptoms like dysphagia, regurgitation, weight loss and chest pain. 10,15 Factors such as tumour size of more than 4 to 5 cm, presence of symptoms, location of the tumour, mucosal ulcerations and if malignancy cannot be ruled out, are considered as indications for surgical intervention whereas asymptomatic lesions and lesions < 4 to 5 cm in size can be managed conservatively with regular follow-up UGIE and contrast studies. 10,16 A proposed algorithm for management has been mentioned below (Fig.…”