Year 2006 / Volume 98 / Number 5
Original
Surgical treatment of esophageal leiomyoma: an analysis of our experience

pp. 350-358

P. Priego, E. Lobo, G. Rodríguez, N. Alonso, M. A. Gil Olarte, J. Pérez de Oteyza and V. Fresneda

Abstract
Introduction: leiomyoma is the most common benign esophageal neoplasm. Surgical treatment (enucleation) has traditionally
been the therapy of choice. The advent of minimally invasive techniques has produced an increase in endoscopic approaches to the detriment of open surgery.
Objective: the aim of this study was to compare the results obtained with open surgery and with laparoscopic surgery in this
kind of pathology.
Material and methods: we performed a retrospective study of all leiomyomas operated for in our center between 1986 and 2004, and obtained 9 cases of esophageal leiomyoma. Four were
women and five men, between the ages of 40 and 70, with a mean age of 53.5 years. The most frequent symptoms were heartburn
(5 cases), dysphagia (3 cases), and retrosternal pain (3 cases).
Surgery was in all the cases an enucleation. An open approach was performed in 5 cases (3 thoracotomies and 2
laparotomies), and an endoscopic approach in 4 (2 thoracoscopies
and 2 laparoscopies).
Results: the mean postoperative hospital stay was 5.12 days
(range 2-8 days). This was shorter for endoscopic approaches versus
open surgery (3.25 vs. 7 days). There was no case of esophageal
mucosal perforation or reconversion. No death, intraoperative
complication, or tumor relapse was described. Only 2 patients
had complications: post-surgical thoracic pain, and intestinal obstruction
by adhesions 8 years after surgery.
Conclusion: enucleation is an easier procedure and constitutes
the therapy of choice for esophageal leiomyoma. This approach
has to be laparoscopic. We think that muscle borders should
be closed after enucleation, and that biopsy is not indicated preoperatively.
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P. Priego, E. Lobo, G. Rodríguez, N. Alonso, M. A. Gil Olarte, J. Pérez de Oteyza and V. Fresneda. Surgical treatment of esophageal leiomyoma: an analysis of our experience. 350-358


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