Videothoracoscopic treatment of oesophageal leiomyoma
- Division of General Surgery, Ospedale San Giuseppe dei Fatebenefratelli, Department of General Surgery, University of Milan, Italy
- Professor G C Roviaro, Cattedra di Chirurgia Generale, Università di Milano, Ospedale San Giuseppe FbF, Via San Vittore 12, 20123 Milano, Italy.
- Received 22 April 1997
- Revision requested 19 June 1997
- Revised 12 September 1997
- Accepted 3 December 1997
Abstract
BACKGROUND Oesophageal leiomyomas are usually so easily removed that thoracotomy seems out of proportion and thoracoscopic removal is therefore highly desirable.
METHODS Out of a total of 1003 thoracoscopic operations undertaken between July 1991 and December 1996, seven patients underwent thoracoscopic removal of oesophageal leiomyoma. All of them had been preoperatively studied by oesophagogastroscopy and computed tomographic scanning of the chest which had confirmed the presence of a lesion with benign features. The surgical technique required intubation with a double lumen tube. Operative access was gained through the right chest via three ports and a small utility thoracotomy in the inframammary sulcus. The mean operating time was 120 minutes.
RESULTS Conversion to open thoracotomy was necessary in one case with a very large horseshoe-shaped leiomyoma which was firmly adherent. The mean postoperative hospital stay was seven days. No intraoperative deaths or postoperative complications occurred.
CONCLUSIONS The simplicity and safety of the thoracoscopic approach, combined with reduced surgical trauma and postoperative pain and functional and cosmetic advantages, make this technique the approach of choice for the removal of oesophageal leiomyomas.
