Department of Surgery, Iwate Medical University School of Medicine, Uchimaru Morioka, Japan.
Dis Esophagus. 2010 Jan;23(1):E1-4. doi: 10.1111/j.1442-2050.2008.00917.x. Epub 2009 Jan 9.
Benign esophageal tumor is a rare entity, with leiomyoma being the most common lesion. We present our experience with enucleation of esophageal leiomyomas using a minimally invasive approach. Between March 1998 and June 2008, seven patients with esophageal leiomyoma underwent right thoracosopic enucleation (n=4) or laparoscopic transhiatal enucleation (n=3). A Dor (n=2) or Toupet fundoplication (n=1) were added for laparoscopic procedure. The mean tumor size was 3.9 cm (range, 1.5-5.5 cm). Tumor locations were upper (n=2), middle (n=1), and lower (n=4) thirds of the esophagus. No major morbidities including postoperative leakage or mortalities occurred. At a mean follow-up period of 60.1 months (range, 14-260 months), no evidence of recurrences were observed. Thoracoscopic and laparoscopic transhiatal enucleation for esophageal leiomyomas is a safe and feasible procedure. The optimal approaches should be tailored based on the location and size of the tumor.
良性食管肿瘤较为少见,其中平滑肌瘤最为常见。我们介绍了采用微创方法经食管平滑肌瘤剜除术的经验。1998 年 3 月至 2008 年 6 月,7 例食管平滑肌瘤患者接受了右胸腔镜剜除术(n=4)或腹腔镜经食管裂孔切除术(n=3)。腹腔镜手术中加行 Dor 或 Toupet 胃底折叠术(n=2 和 1)。肿瘤平均大小为 3.9cm(范围,1.5-5.5cm)。肿瘤位于食管上 1/3(n=2)、中 1/3(n=1)和下 1/3(n=4)。无重大并发症发生,包括术后漏诊或死亡。平均随访 60.1 个月(范围,14-260 个月),未见复发迹象。胸腔镜和腹腔镜经食管裂孔切除术治疗食管平滑肌瘤是一种安全可行的方法。应根据肿瘤的位置和大小选择最佳方法。