Skip to main content
SpringerLink
Log in

Enucleation of submucosal tumors of the esophagus: minimally invasive versus open approach

  • Original article
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Surgical enucleation of submucosal tumors (SMTs) of the esophagus (mostly leiomyomas) is indicated when either the tumors are symptomatic or their biological behavior is unclear. The classic approach is a thoracotomy, but tumor enucleation can now also be performed via thoracoscopy or, for distal tumors, via laparoscopy.

Methods

We assessed our experience with the different approaches in a total of 25 patients (n = 13 minimally invasive approach and n = 12 open surgery). Enucleation of the SMT was the basic surgical principle; the choice of the approach was based on the preference of the surgeon.

Results

Compared to open surgery, the minimally invasive approach reduced pulmonary complications, hospital stay, and postoperative wound-related pain. The operating time was the same for both approaches.

Conclusion

Minimally invasive approaches are suitable for the surgical enucleation of submucosal esophageal tumors. Thoracoscopic and laparoscopic techniques are recommended as standard procedures in experienced centers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. J Alvarez Fernandez-Represa E Ortiz-Oshiro J Mayol R Peromingo MJ Perez Contin (1996) ArticleTitleExcision of esophageal leiomyoma using videothoracoscopy. Rev Esp Enferm Dig 88 799–800 Occurrence Handle1:STN:280:DyaK2s7it1ygtg%3D%3D Occurrence Handle9004786

    CAS  PubMed  Google Scholar 

  2. R Bardini M Asolati (1997) ArticleTitleThoracoscopic resection of benign tumours of the esophagus. Int Surg 82 5–6 Occurrence Handle1:STN:280:DyaK2szjtlKhug%3D%3D Occurrence Handle9189788

    CAS  PubMed  Google Scholar 

  3. R Bardini A Segalin M Asolati L Bonavina M Pavanello (1993) ArticleTitleThoracoscopic removal of benign tumors of the oesophagus. Endosc Surg 1 277–279 Occurrence Handle1:STN:280:DyaK2czmtlCiug%3D%3D

    CAS  Google Scholar 

  4. R Bardini A Segalin A Ruol M Pavanello A Peracchia (1992) ArticleTitleVideothoracoscopic enucleation of esophageal leiomyoma. Ann Thorac Surg 54 576–577 Occurrence Handle1:STN:280:DyaK38znvVektQ%3D%3D Occurrence Handle10.1016/0003-4975(92)90463-E

    Article  CAS  Google Scholar 

  5. L Bonavina A Segalin R Rosati M Pavanello A Peracchia (1995) ArticleTitleSurgical therapy of esophageal leiomyoma. J Am Coll Surg 181 257–262 Occurrence Handle1:STN:280:DyaK2MvgtVGnsQ%3D%3D Occurrence Handle7670685

    CAS  PubMed  Google Scholar 

  6. AJ Bryan IAF Bucharan FC Wells (1990) ArticleTitleSaccular esophageal diverticulum at the site of enucleation of a leiomyoma. Eur J Cardiothorac Surg 4 624–625 Occurrence Handle1:STN:280:DyaK3M%2Fpslynsg%3D%3D Occurrence Handle10.1016/1010-7940(90)90023-S

    Article  CAS  Google Scholar 

  7. AC Chan SC Chung (1997) ArticleTitleEndoscopic surgery of the oesophagus. Eur J Gastroenterol Hepatol 9 761–765 Occurrence Handle1:STN:280:DyaK2svislWktw%3D%3D Occurrence Handle10.1097/00042737-199708000-00005

    Article  CAS  Google Scholar 

  8. MA Cox BT Cooper G Sagas (1995) ArticleTitleEndoscopy and computed tomography in the diagnosis and follow-up of esophageal leiomyoma. Gut 37 288–291 Occurrence Handle1:STN:280:DyaK28%2FjtVKmsQ%3D%3D Occurrence Handle10.1136/gut.37.2.288

    Article  CAS  Google Scholar 

  9. J de Csepel G Jossart BA Salky (2001) ArticleTitleLaparoscopic resection of an extraesophageal leiomyoma presenting as an intra-abdominal mass. Surg Laparosc Endosc Percutan Tech 11 116–118 Occurrence Handle1:STN:280:DC%2BD3MrgsV2mtw%3D%3D Occurrence Handle11330376

    CAS  PubMed  Google Scholar 

  10. NJ Everitt M Glinatsis MJ McMahon (1992) ArticleTitleThoracoscopic enucleation of leiomyoma of the oesophagus. Br J Surg 79 643 Occurrence Handle1:STN:280:DyaK38zltlOqsA%3D%3D Occurrence Handle10.1002/bjs.1800790715

    Article  CAS  Google Scholar 

  11. D Gossot P Fourquier (1993) ArticleTitleThoracoscopic resection of benign intramural tumors of the esophagus. Gastroenterol Clin Biol 17 215–217 Occurrence Handle1:STN:280:DyaK3szitFyhsg%3D%3D Occurrence Handle8330696

    CAS  PubMed  Google Scholar 

  12. D Gossot P Fourquier M el Meteini M Celerier (1993) ArticleTitleTechnical aspects of endoscopic removal of benign tumors of the esophagus. Surg Endosc 7 102–103 Occurrence Handle1:STN:280:DyaK3s3gs1WqtQ%3D%3D Occurrence Handle10.1007/BF00704389

    Article  CAS  Google Scholar 

  13. JP Hurley J McCarthy AE Wood (1993) ArticleTitleVideo assisted thoracic surgery. Ir J Med Sci 162 466–468 Occurrence Handle1:STN:280:DyaK2c7ls1Kkug%3D%3D Occurrence Handle10.1007/BF02942191

    Article  CAS  Google Scholar 

  14. M Infante M Alloisio PB Massone G Ravasi (2001) ArticleTitleThoracoscopic resection of an esophageal stromal tumor through the left pleural cavity. Surg Laparosc Endosc Percutan Tech 11 273–276 Occurrence Handle1:STN:280:DC%2BD3Mvot1Ciug%3D%3D Occurrence Handle10.1097/00129689-200108000-00009

    Article  CAS  Google Scholar 

  15. Y Izumi H Inoue M Endo (1996) ArticleTitleCombined endoluminal–intracavitary thoracoscopic enucleation of leiomyoma of the esophagus. A new method. Surg Endosc 10 457–458 Occurrence Handle1:STN:280:DyaK283msF2nuw%3D%3D Occurrence Handle10.1007/BF00191641

    Article  CAS  Google Scholar 

  16. Y Izumi H Inoue K Takeshita T Kawano K Yoshino M Endo (1995) ArticleTitleThoracoscopic enucleation of leiomyoma of the esophagus—report of two cases. Nippon Kyobu Geka Gakkai Zasshi 43 216–220 Occurrence Handle1:STN:280:DyaK2M3jtVWgtA%3D%3D Occurrence Handle7714387

    CAS  PubMed  Google Scholar 

  17. K Kondoh A Mitsui T Kasugai T Urakami (1997) ArticleTitleThoracoscopic surgery for benign esophageal diseases. Kyobu Geka 50 838–843 Occurrence Handle1:STN:280:DyaK2svks1Kmug%3D%3D Occurrence Handle9301178

    CAS  PubMed  Google Scholar 

  18. K Mafune Y Tanaka (1997) ArticleTitleThoracoscopic enucleation of an esophageal leiomyoma with balloon dilator assistance. Surg Today 27 189–192 Occurrence Handle1:STN:280:DyaK2s7ntVKquw%3D%3D Occurrence Handle10.1007/BF02385915

    Article  CAS  Google Scholar 

  19. JP Marmuse H Johanet F Louvent G Benhamou (1994) ArticleTitleLeiomyomas of the lower third of the esophagus: value of transhiatal enucleation. Ann Chir 48 446–451 Occurrence Handle1:STN:280:DyaK2M7htVShtg%3D%3D Occurrence Handle7810978

    CAS  PubMed  Google Scholar 

  20. M Miettinen M Sarlomo-Rikala LH Sobin J Lasota (2000) ArticleTitleEsophageal stromal tumors: a clinicopathologic, immunohistochemical, and molecular genetic study of 17 cases and comparison with esophageal leiomyomas and leiomyosarcomas. Am J Surg Pathol 24 211–222 Occurrence Handle1:STN:280:DC%2BD3c7ktlWhtg%3D%3D Occurrence Handle10.1097/00000478-200002000-00007

    Article  CAS  Google Scholar 

  21. NT Nguyen JJ Alcocer JD Luketich (2000) ArticleTitleThoracoscopic enucleation of an esophageal leiomyoma. J Clin Gastroenterol 31 89–90 Occurrence Handle1:STN:280:DC%2BD3M%2Fks1aktA%3D%3D Occurrence Handle10.1097/00004836-200007000-00023

    Article  CAS  Google Scholar 

  22. A Peracchia U Fumagalli R Rosati (1994) ArticleTitleThoracoscopic techniques in treatment of esophageal diseases. Chirurg 65 671–676 Occurrence Handle1:STN:280:DyaK2M%2FksVKisw%3D%3D Occurrence Handle7956531

    CAS  PubMed  Google Scholar 

  23. RW Postlethwaite (1983) ArticleTitleBenign tumors and cysts of the esophagus. Surg Clin North Am 63 925–931 Occurrence Handle10.1016/S0039-6109(16)43093-8

    Article  Google Scholar 

  24. M Pross T Manger S Wolff S Kahl H Lippert (2000) ArticleTitleThoracoscopic enucleation of benign tumors of the esophagus under simultaneous flexible esophagoscopy. Surg Endosc 14 1146–1148 Occurrence Handle1:STN:280:DC%2BD3M7htFCjuw%3D%3D Occurrence Handle10.1007/s004640000258

    Article  CAS  Google Scholar 

  25. GC Roviaro M Maciocco F Varoli C Rebuffat C Vergani A Scarduelli (1998) ArticleTitleVideothoracoscopic treatment of oesophageal leiomyoma. Thorax 53 190–192 Occurrence Handle1:STN:280:DyaK1czitlGgsA%3D%3D Occurrence Handle10.1136/thx.53.3.190

    Article  CAS  Google Scholar 

  26. AH Rusher K Davis D Phillips L Wiggins (2001) ArticleTitleOpen versus thoracoscopic removal of left-sided mid-esophageal leiomyoma. J Ark Med Soc 97 247–249 Occurrence Handle1:STN:280:DC%2BD3M%2FpvVyqsQ%3D%3D Occurrence Handle11189104

    CAS  PubMed  Google Scholar 

  27. JA Salo T Kiviluoto L Heikkila V Perhoniemi A Lamminen E Kivilaakso (1993) ArticleTitleEnucleation of an intramural lipoma of the oesophagus by videothoracoscopy. Ann Chir Gynaecol 82 66–69 Occurrence Handle1:STN:280:DyaK3szhtF2msw%3D%3D Occurrence Handle8323241

    CAS  PubMed  Google Scholar 

  28. RA Schmid OM Schob HP Klotz P Vogt W Weder (1997) ArticleTitleVATS resection of an oesophageal leiomyoma in a patient with neurofibromatosis Recklinghausen. Eur J Cardiothorac Surg 12 659–662 Occurrence Handle1:STN:280:DyaK1c%2Fjs1Wrsw%3D%3D Occurrence Handle10.1016/S1010-7940(97)00210-8

    Article  CAS  Google Scholar 

  29. M Seremetis W Lyons V DeGuzman J Peabody (1976) ArticleTitleLeiomyomata of the esophagus. Cancer 38 2166–2177 Occurrence Handle1:STN:280:DyaE2s%2Fks1yquw%3D%3D Occurrence Handle10.1002/1097-0142(197611)38:5<2166::AID-CNCR2820380547>3.0.CO;2-B

    Article  CAS  Google Scholar 

  30. GS Smith JR Isaacson MB Dempsey GL Falk (2001) ArticleTitleLaparoscopic excision of esophageal leiomyoma through an anterior esophagotomy. Dis Esophagus 14 278–279 Occurrence Handle1:STN:280:DC%2BD387jtl2ktw%3D%3D Occurrence Handle10.1046/j.1442-2050.2001.00203.x

    Article  CAS  Google Scholar 

  31. N Takada M Higashino H Osugi T Tokuhara H Kinoshita (1999) ArticleTitleUtility of endoscopic ultrasonography in assessing the indications for endoscopic surgery of submucosal esophageal tumors. Surg Endosc 13 228–230 Occurrence Handle1:STN:280:DyaK1M7msFyqug%3D%3D Occurrence Handle10.1007/s004649900950

    Article  CAS  Google Scholar 

  32. M Takernura M Higashino H Osugi T Tokuhara N Takada H Kinoshita (1997) ArticleTitleThoracoscopic enucleation of esophageal leiomyomal. Nippon Kyobu Geka Gakkai Zasshi 45 1606–1611

    Google Scholar 

  33. K Tamura S Takamori K Tayama M Mitsuoka A Hayashi H Fujita K Shirouzu (1998) ArticleTitleThoracoscopic resection of a giant leiomyoma of the esophagus with a mediastinal outgrowth. Ann Thorac Cardiovasc Surg 4 351–353 Occurrence Handle1:STN:280:DyaK1M7hsF2ktg%3D%3D Occurrence Handle9914465

    CAS  PubMed  Google Scholar 

  34. E Taniguchi W Kamiike K Iwase T Nishida A Akashi S Ohashi H Matsuda (1997) ArticleTitleThoracoscopic enucleation of a large leiomyoma located on the left side of the esophageal wall. Surg Endosc 11 280–282 Occurrence Handle1:STN:280:DyaK2s3js1Ogug%3D%3D Occurrence Handle10.1007/s004649900344

    Article  CAS  Google Scholar 

  35. F Tosato L Vasapollo U Passaro F Scocchera L Carnevale M Tosato F Corsini S Marano S Palermo A Paolini G Fegiz (1999) ArticleTitleSurgery of dysphagic diseases. Personal experience (349 surgical interventions). Minerva Chir 54 869–884 Occurrence Handle1:STN:280:DC%2BD3c3gtFagsA%3D%3D Occurrence Handle10736993

    CAS  PubMed  Google Scholar 

  36. P Eijkelenburg ParticleVan T Bove O Peters G Delvaux G Willems (1996) ArticleTitleThoracoscopic removal of a leiomyoma of the oesophagus: a case report. Acta Chir Belgium 96 223–225

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Technical University Munich, Ismaningerstrasse 22, 81675, Munich, Germany

    B. H. A. von Rahden, H. J. Stein, H. Feussner & J. R. Siewert

Authors
  1. B. H. A. von Rahden
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. J. Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Feussner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. R. Siewert
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. J. Stein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

von Rahden, B.H.A., Stein, H.J., Feussner, H. et al. Enucleation of submucosal tumors of the esophagus: minimally invasive versus open approach. Surg Endosc 18, 924–930 (2004). https://doi.org/10.1007/s00464-003-9130-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-003-9130-9

Keywords

Search

Navigation