Starkov Yu G, Dzhantukhanova S V, Zamolodchikov R D, Badakhova A B
Vishnevsky National Medical Research Center of Surgery, Moscow, Russia.
Khirurgiia (Mosk). 2023(11):123-132. doi: 10.17116/hirurgia2023111123.
Fibrovascular polyp is a rare non-epithelial esophageal tumor arising from submucosal layer and consisting of connective and adipose tissue, as well large number of vessels. Large tumors can cause dysphagia, vomiting, chest pain, shortness of breath and/or asthma, while giant neoplasms are potentially life threatening. Despite active introduction of minimally invasive treatment of patients with non-epithelial gastrointestinal tumors, there are still difficulties in surgical treatment of fibrovascular polyps. The patient with a giant fibrovascular esophageal polyp presented with cough, discomfort in the throat, impaired swallowing and episode of tumor migration into oropharynx. Examination confirmed giant highly vascularized esophageal fibrovascular polyp. A novel hybrid surgical technique (endoscopic submucosal dissection with laparoscopic removal of tumor) was applied. Eight-month follow-up revealed no complications. Favorable clinical result was achieved. A hybrid laparo-endoscopic approach in the treatment of patients with large fibrovascular polyps minimizes perioperative risks and improves postoperative outcomes.
纤维血管性息肉是一种罕见的非上皮性食管肿瘤，起源于黏膜下层，由结缔组织、脂肪组织以及大量血管构成。较大的肿瘤可导致吞咽困难、呕吐、胸痛、呼吸急促和/或哮喘，而巨大肿瘤则可能危及生命。尽管非上皮性胃肠道肿瘤患者的微创治疗已得到积极推广，但纤维血管性息肉的手术治疗仍存在困难。一名患有巨大纤维血管性食管息肉的患者出现咳嗽、咽喉不适、吞咽障碍以及肿瘤移入口咽的情况。检查证实为巨大的高度血管化食管纤维血管性息肉。采用了一种新型的联合手术技术（内镜黏膜下剥离术联合腹腔镜肿瘤切除术）。八个月的随访显示无并发症发生。取得了良好的临床效果。联合腹腔镜 - 内镜方法治疗巨大纤维血管性息肉可将围手术期风险降至最低，并改善术后结果。
