Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb;48(1):40-5.
doi: 10.5090/kjtcs.2015.48.1.40. Epub 2015 Feb 5.

Retrospective analysis of thoracoscopic surgery for esophageal submucosal tumors

Seung Ku Kang  1 , Ju Sik Yun  1 , Sang Hyung Kim  2 , Sang Yun Song  1 , Yochun Jung  3 , Kook Joo Na  1
Affiliations

Retrospective analysis of thoracoscopic surgery for esophageal submucosal tumors

Seung Ku Kang et al. Korean J Thorac Cardiovasc Surg. 2015 Feb.

Abstract

Background: Surgical enucleation is the treatment of choice for esophageal submucosal tumors (SMTs) with symptomatic, larger, or ill-defined lesions. The enucleation of SMTs has traditionally been performed via thoracotomy. However, minimally invasive approaches have recently been introduced and successfully applied. In this study, we present our experiences with the thoracotomic and thoracoscopic approaches to treating SMTs.

Methods: We retrospectively reviewed 53 patients with SMTs who underwent surgical enucleation between August 1996 and July 2013. Demographic and clinical features, tumor-related factors, the surgical approach, and outcomes were analyzed.

Results: There were 36 males (67.9%) and 17 females (32.1%); the mean age was 49.2±11.8 years (range, 16 to 79 years). Histology revealed leiomyoma in 51 patients, a gastrointestinal stromal tumor in one patient, and schwannoma in one patient. Eighteen patients (34.0%) were symptomatic. Fourteen patients underwent a planned thoracotomic enucleation. Of the 39 patients for whom a thoracoscopic approach was planned, six patients required conversion to thoracotomy because of overly small tumors or poor visualization in five patients and accidental mucosal injury in one patient. No mortality or major postoperative complications occurred. Compared to thoracotomy, the thoracoscopic approach had a slightly shorter operation time, but this difference was not statistically significant (120.0±45.6 minutes vs. 161.5±71.1 minutes, p=0.08). A significant difference was found in the length of the hospital stay (9.0±3.2 days vs. 16.5±5.4 days, p<0.001).

Conclusion: The thoracoscopic enucleation of submucosal esophageal tumors is safe and is associated with a shorter length of hospital stay compared to thoracotomic approaches.

Keywords: Enucleation; Esophagus, surgery; Submucosal tumors of the esophagus; Thoracoscopy.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
A graph showing the distribution of operation time and hospital stay for the thoracoscopy and thoracotomy groups. (A) The median operation time (min): 120.0±45.6 vs. 161.5±71.1, p=0.080. (B) The median length of hospital stay (day): 9.0±3.2 vs. 16.5±5.4, p<0.001.
Fig. 2
Fig. 2
Tumor size and distribution in the thoracoscopy and thoracotomy groups. T, tumor size.
See this image and copyright information in PMC

References

    1. Seremetis MG, Lyons WS, deGuzman VC, Peabody JW., Jr Leiomyomata of the esophagus: an analysis of 838 cases. Cancer. 1976;38:2166–77. doi: 10.1002/1097-0142(197611)38:5<2166::AID-CNCR2820380547>3.0.CO;2-B. - DOI - PubMed
    1. Miettinen M, Sarlomo-Rikala M, Sobin LH, Lasota J. Esophageal stromal tumors: a clinicopathologic, immunohistochemical, and molecular genetic study of 17 cases and comparison with esophageal leiomyomas and leiomyosarcomas. Am J Surg Pathol. 2000;24:211–22. doi: 10.1097/00000478-200002000-00007. - DOI - PubMed
    1. Blum MG, Bilimoria KY, Wayne JD, de Hoyos AL, Talamonti MS, Adley B. Surgical considerations for the management and resection of esophageal gastrointestinal stromal tumors. Ann Thorac Surg. 2007;84:1717–23. doi: 10.1016/j.athoracsur.2007.05.071. - DOI - PubMed
    1. Von Rahden BH, Stein HJ, Feussner H, Siewert JR. Enucleation of submucosal tumors of the esophagus: minimally invasive versus open approach. Surg Endosc. 2004;18:924–30. doi: 10.1007/s00464-003-9130-9. - DOI - PubMed
    1. Shin S, Choi YS, Shim YM, Kim HK, Kim K, Kim J. Enucleation of esophageal submucosal tumors: a single institution’s experience. Ann Thorac Surg. 2014;97:454–9. doi: 10.1016/j.athoracsur.2013.10.030. - DOI - PubMed

LinkOut - more resources