Yalçınkaya İrfan, Ocakcıoğlu İlhan, Tuncer İlyas
Department of Thoracic Surgery, Health Science University, Süreyyapaşa Chest Disease and Chest Surgery, Research and Training Hospital, Istanbul, Turkey.
Department of Thoracic Surgery, Health Science University, Sancaktepe Training and Research Hospital, Istanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Jul 28;28(3):505-513. doi: 10.5606/tgkdc.dergisi.2020.18889. eCollection 2020 Jul.
In this study, we aimed to evaluate the surgical outcomes after enucleation of esophageal leiomyomas and present the feasibility of enucleation using video-assisted thoracoscopic surgery.
The medical records of 13 patients (8 males, 5 females; mean age 45.9 years; range, 30 to 69 years) who underwent open or thoracoscopic surgery for an esophageal leiomyoma between April 2007 and June 2019 were retrospectively reviewed. The patients were evaluated with regard to age, sex, presenting symptoms, duration of symptoms, size and localization of tumors, diagnostic methods, surgical methods, conversion to open surgery, morbidity and mortality, discharge time, and follow-up period.
Of the patients, four were operated via thoracotomy and nine via video-assisted thoracoscopic surgery. Enucleation was successfully completed with thoracoscopy in five patients. Four patients required conversion to thoracotomy. In the early postoperative period, two of these four patients developed complications and underwent re-thoracotomy. A solitary leiomyoma was detected in all, but one patient (multiple). The mean size of the tumors was 68.4 mm. Complications were seen in only one patient during follow-up and no recurrence was observed in any patient.
Our study results indicate that thoracoscopic enucleation of esophageal leiomyoma is a safe, feasible, and effective technique in selected patients and conversion to open surgery can be easily done for any reason during the procedure.
在本研究中,我们旨在评估食管平滑肌瘤摘除术后的手术效果,并介绍使用电视辅助胸腔镜手术进行摘除的可行性。
回顾性分析2007年4月至2019年6月期间13例因食管平滑肌瘤接受开放手术或胸腔镜手术患者的病历(8例男性,5例女性;平均年龄45.9岁;范围30至69岁)。对患者的年龄、性别、临床表现、症状持续时间、肿瘤大小和位置、诊断方法、手术方法、中转开放手术情况、发病率和死亡率、出院时间及随访时间进行评估。
患者中,4例通过开胸手术,9例通过电视辅助胸腔镜手术。5例患者通过胸腔镜成功完成摘除。4例患者需要中转开胸手术。在术后早期,这4例患者中有2例出现并发症并接受了再次开胸手术。除1例患者为多发外,其余均为单发平滑肌瘤。肿瘤平均大小为68.4毫米。随访期间仅1例患者出现并发症,所有患者均未观察到复发。
我们的研究结果表明,对于部分患者,电视胸腔镜下食管平滑肌瘤摘除术是一种安全、可行且有效的技术,并且在手术过程中可因任何原因轻松中转至开放手术。