Thoracoscopic Enucleation of Esophageal Benign Tumors

Abstract

Benign esophageal tumors are rare, with a prevalence of 0.005–5.1 %, based on autopsy results, and account for <1–10 % of all esophageal neoplasms. Leiomyomas constitute 70–80 % of these benign esophageal neoplasms. Other benign esophageal tumors, such as granular cell tumors or schwannomas, are extremely rare. Esophageal leiomyomas are usually detected in patients between 20 and 50 years of age, with a twofold male predominance, and most commonly occur in the lower third of the esophagus. At least 50 % of patients with esophageal leiomyomas are asymptomatic; in symptomatic individuals, dysphagia is the most commonly reported symptom, followed by chest tightness and pain. These tumors are usually discovered, incidentally, during esophagography or endoscopic examination of the upper gastrointestinal tract for unrelated reasons. The treatment strategy for esophageal benign tumors, such as leiomyomas, involves continued monitoring of smaller tumors and surgical resection of larger or symptomatic tumors. Conventional, open thoracotomy for enucleation of this tumor type has been gradually replaced by less invasive thoracoscopic or laparoscopic approaches. In the present report, we describe our experience with patients undergoing surgical enucleation of esophageal leiomyomas via thoracoscopic or laparoscopic approaches.