Surgical Therapy for Leiomyoma of the Esophagus

Masashi Takemura, Harushi Osugi, Taigo Tokuhara, Nobuyasu Takada, Yoshihiko Nishimura, Yoshikazu Fukuda, Hiroshi Kato, Hiroaki Kinoshita and Masayuki Higashino^*

Second Department of Surgery, Osaka City University Medical School
^*Department of Gastrointestinal Surgery, Osaka City General Hospital

Leiomyoma is the most frequent submucosal benign tumor of the esophagus. Recently, most patients of leiomyoma of the esophagus have been asymptomatic at diagnosis and the tumor is often detected in a health examination for an examination of other disease. In this study, we examined 14 cases of recected esophageal leiomyoma clinicopathologically. In preoperative endoscopic ultrasonography, 15 lesions were detected in low echoic and homogenous submucosal tumors and two lesions were heterogenous. Endoscopic resection of leiomyoma was performed in three cases. These lesions were diagnosed as originating from muscularis mucosae by preoperative endoscopic ultrasonography. Esophagectomy was performed in two cases, because of suspected esophageal leiomyosarcoma in one case and complication with esophageal carcinoma at the covered mucosa of leiomyoma in the other. Enucleation of esophageal leiomyoma was performed in nine cases, four of them performed by the thoracoscopic procedure. The postoperative course after thoracoscopic enucleation was not different from that after conventional thoracotomy. We concluded that the thoracoscopic removal of esophageal leiomyoma is as effective and safe as enucleation by thoracotomy. And endoscopic ultrasonography is an effective diagnostic procedure for clinical management of leiomyoma of the esophagus.

Key words
leiomyoma of the esophagus, thoracoscopic enucleation for leiomyoma of the esophagus,
endoscopic ultrasonography, endoscopic resection for leiomyoma of the esophagus

Reprint requests
Masashi Takemura Second Department of Surgery, Osaka City Medical School 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586 JAPAN

Accepted
November 13, 1998

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