Skip to main content

Thoracoscopic Management of Benign Submucosal Tumors

  • Chapter
  • First Online:
The SAGES Manual of Foregut Surgery
  • 1503 Accesses

Abstract

Benign submucosal tumors of the esophagus are rare, with leiomyoma accounting for the majority of cases. Although the management of small asymptomatic benign submucosal tumors is debated, tumors that are symptomatic, large, or require a pathologic diagnosis to rule out malignancy should be removed, preferably by tumor enucleation. The thoracoscopic approach has been increasingly used for benign esophageal submucosal tumors and is similar to the open thoracotomy approach in many aspects without compromising successful exposure, mobilization, or tumor enucleation. Thoracoscopic enucleation has been demonstrated to be a technically feasible and safe alternative to the traditional thoracotomy, with shorter hospital stays, less postoperative pain, and no difference in functional outcomes.

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hatch GF 3rd, Wertheimer-Hatch L, Hatch KF, Davis GB, Blanchard DK, Foster RS Jr, et al. Tumors of the esophagus. World J Surg. 2000;24:401–11.

    Article  Google Scholar 

  2. KM FMA. Benign tumors, cysts, and duplications of the esophagus. In: Shields TW, JR LC, Feins CE, et al., editors. General thoracic surgery. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 7e.

    Google Scholar 

  3. Mutrie CJ, Donahue DM, Wain JC, Wright CD, Gaissert HA, Grillo HC, et al. Esophageal leiomyoma: a 40-year experience. Ann Thorac Surg. 2005;79:1122–5.

    Article  Google Scholar 

  4. 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.

    Article  Google Scholar 

  5. Roviaro GC, Maciocco M, Varoli F, Rebuffat C, Vergani C, Scarduelli A. Videothoracoscopic treatment of oesophageal leiomyoma. Thorax. 1998;53:190–2.

    Article  CAS  Google Scholar 

  6. Bonavina L, Segalin A, Rosati R, Pavanello M, Peracchia A. Surgical therapy of esophageal leiomyoma. J Am Coll Surg. 1995;181:257–62.

    CAS  PubMed  Google Scholar 

  7. Seremetis MG, Lyons WS, VC dG, Peabody JW Jr. Leiomyomata of the esophagus. An analysis of 838 cases. Cancer. 1976;38:2166–77.

    Article  CAS  Google Scholar 

  8. Choong CK, Meyers BF. Benign esophageal tumors: introduction, incidence, classification, and clinical features. Semin Thorac Cardiovasc Surg. 2003;15:3–8.

    Article  Google Scholar 

  9. Paruch JZM, Ferguson MK. Resection of benign tumors of the esophagus. In: Sugarbaker DJ, Bueno R, Colson YL, Jaklitsch MT, Krasna MJ, Mentzer SJ, et al., editors. Adult chest surgery. New York: McGraw-Hill Education; 2009. p. 2e.

    Google Scholar 

  10. Samphire J, Nafteux P, Luketich J. Minimally invasive techniques for resection of benign esophageal tumors. Semin Thorac Cardiovasc Surg. 2003;15:35–43.

    Article  Google Scholar 

  11. Lee LS, Singhal S, Brinster CJ, Marshall B, Kochman ML, Kaiser LR, et al. Current management of esophageal leiomyoma. J Am Coll Surg. 2004;198:136–46.

    Article  Google Scholar 

  12. Arnorsson T, Aberg C, Aberg T. Benign tumours of the oesophagus and oesophageal cysts. Scand J Thorac Cardiovasc Surg. 1984;18:145–50.

    Article  CAS  Google Scholar 

  13. Hanel K, Talley NA, Hunt DR. Hemangioma of the esophagus: an unusual cause of upper gastrointestinal bleeding. Dig Dis Sci. 1981;26:257–63.

    Article  CAS  Google Scholar 

  14. Palazzo L, Landi B, Cellier C, Roseau G, Chaussade S, Couturier D, et al. Endosonographic features of esophageal granular cell tumors. Endoscopy. 1997;29:850–3.

    Article  CAS  Google Scholar 

  15. Coutinho DSS, Soga J, Yoshikawa T, Miyashita K, Tanaka O, Sasaki K, et al. Granular cell tumors of the esophagus: a report of two cases and review of the literature. Am J Gastroenterol. 1985;80:758–62.

    CAS  PubMed  Google Scholar 

  16. Akiyama S, Kataoka M, Horisawa M, Inoue S, Sakai M, Ito K, et al. Lipoma of the esophagus—Report of a case and review of the literature. Jpn J Surg. 1990;20:458–62.

    Article  CAS  Google Scholar 

  17. Nishikawa K, Omura N, Yuda M, Tanaka Y, Matsumoto A, Tanishima Y, et al. Video-assisted thoracoscopic surgery for localized neurofibroma of the esophagus: case report and review of the literature. Int Surg. 2013;98:461–5.

    Article  Google Scholar 

  18. Yoon YH, Kim KH, Baek WK, Kim JT, Son KH, Han JY, et al. Lymphangioma of the esophagus: surgical treatment. Ann Thorac Surg. 2004;78:e51–e3.

    Article  Google Scholar 

  19. Everett C, Volberg F, Ulshen M, Murray G. Intramural esophageal hamartoma: A report of two cases and review of the literature. Gastrointest Radiol. 1980;5:317–9.

    Article  CAS  Google Scholar 

  20. Kim AW, Korst RJ, Port JL, Altorki NK, Lee PC. Giant cavernous hemangioma of the distal esophagus treated with esophagectomy. J Thorac Cardiovasc Surg. 2007;133:1665–7.

    Article  Google Scholar 

  21. Rijcken E, Kersting CM, Senninger N, Bruewer M. Esophageal resection for giant leiomyoma: report of two cases and a review of the literature. Langenbeck’s Arch Surg. 2008;394:623.

    Article  Google Scholar 

  22. Yang PS, Lee KS, Lee SJ, Kim TS, Choo I-W, Shim YM, et al. Esophageal leiomyoma: radiologic findings in 12 patients. Korean J Radiol. 2001;2:132–7.

    Article  CAS  Google Scholar 

  23. Rice TW. Benign esophageal tumors: esophagoscopy and endoscopic esophageal ultrasound. Semin Thorac Cardiovasc Surg. 2003;15:20–6.

    Article  Google Scholar 

  24. Everitt NJ, Glinatsis M, McMahon MJ. Thoracoscopic enucleation of leiomyoma of the oesophagus. Br J Surg. 1992;79:643.

    Article  CAS  Google Scholar 

  25. Kent M, d’Amato T, Nordman C, Schuchert M, Landreneau R, Alvelo-Rivera M, et al. Minimally invasive resection of benign esophageal tumors. J Thorac Cardiovasc Surg. 2007;134:176–81.

    Article  Google Scholar 

  26. Aurea P, Grazia M, Petrella F, Bazzocchi R. Giant leiomyoma of the esophagus. Eur J Cardiothorac Surg. 2002;22:1008–10.

    Article  CAS  Google Scholar 

  27. Jobe BA, Hunter JG, Watson DI. Esophagus and diaphragmatic hernia. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, et al., editors. Schwartz’s principles of surgery. 10e ed. New York: McGraw-Hill Education; 2014.

    Google Scholar 

  28. Vogel SB, Rout WR, Martin TD, Abbitt PL. Esophageal perforation in adults: aggressive, conservative treatment lowers morbidity and mortality. Ann Surg. 2005;241:1016–21. discussion 21–3

    Article  Google Scholar 

  29. Nguyen NT, Reavis KM, El-Badawi K, Hinojosa MW, Smith BR. Minimally invasive surgical enucleation or esophagogastrectomy for benign tumor of the esophagus. Surg Innov. 2008;15:120–5.

    Article  Google Scholar 

  30. Jiang G, Zhao H, Yang F, Li J, Li Y, Liu Y, et al. Thoracoscopic enucleation of esophageal leiomyoma: a retrospective study on 40 cases. Dis Esophagus. 2009;22:279–83.

    Article  CAS  Google Scholar 

  31. Bardini R, Asolati M. Thoracoscopic resection of benign tumours of the esophagus. Int Surg. 1997;82:5–6.

    CAS  PubMed  Google Scholar 

  32. Palanivelu C, Rangarajan M, Madankumar MV, John SJ, Senthilkumar R. Minimally invasive therapy for benign tumors of the distal third of the esophagus – a single institute’s experience. J Laparoendosc Adv Surg Tech A. 2008;18:20–6.

    Article  Google Scholar 

  33. Fisichella PM, Soper NJ, Pellegrini CA, Patti MG. Surgical management of benign esophageal disorders. London: Springer; 2014.

    Book  Google Scholar 

  34. Luh S-P, Hou S-M, Fang C-C, Chen C-Y. Video-thoracoscopic enucleation of esophageal leiomyoma. World J Surg Oncol. 2012;10:52.

    Article  Google Scholar 

  35. Obuchi T, Sasaki A, Nitta H, Koeda K, Ikeda K, Wakabayashi G. Minimally invasive surgical enucleation for esophageal leiomyoma: report of seven cases. Dis Esophagus. 2010;23:E1–4.

    Article  CAS  Google Scholar 

  36. Vallbohmer D, Holscher AH, Brabender J, Bollschweiler E, Gutschow C. Thoracoscopic enucleation of esophageal leiomyomas: a feasible and safe procedure. Endoscopy. 2007;39:1097–9.

    Article  CAS  Google Scholar 

  37. Brinster CJ, Singhal S, Lee L, Marshall MB, Kaiser LR, Kucharczuk JC. Evolving options in the management of esophageal perforation. Ann Thorac Surg. 2004;77:1475–83.

    Article  Google Scholar 

  38. Blackmon SH, Santora R, Schwarz P, Barroso A, Dunkin BJ. Utility of removable esophageal covered self-expanding metal stents for leak and fistula management. Ann Thorac Surg. 2010;89:931–7.

    Article  Google Scholar 

  39. Wu JT, Mattox KL, Wall MJ Jr. Esophageal perforations: new perspectives and treatment paradigms. J Trauma. 2007;63:1173–84.

    Article  Google Scholar 

  40. Dasari BV, Neely D, Kennedy A, Spence G, Rice P, Mackle E, et al. The role of esophageal stents in the management of esophageal anastomotic leaks and benign esophageal perforations. Ann Surg. 2014;259:852–60.

    Article  Google Scholar 

  41. Zaninotto G, Portale G, Costantini M, Rizzetto C, Salvador R, Rampado S, et al. Minimally invasive enucleation of esophageal leiomyoma. Surg Endosc. 2006;20:1904–8.

    Article  CAS  Google Scholar 

  42. Banki F, Mason RJ, DeMeester SR, Hagen JA, Balaji NS, Crookes PF, et al. Vagal-sparing esophagectomy: a more physiologic alternative. Ann Surg. 2002;236:324–36.

    Article  Google Scholar 

  43. Watson TJ, DeMeester TR, Kauer WK, Peters JH, Hagen JA. Esophageal replacement for end-stage benign esophageal disease. J Thorac Cardiovasc Surg. 1998;115:1241–7. discussion 7-9

    Article  CAS  Google Scholar 

  44. Nguyen NT, Alcocer JJ, Luketich JD. Thoracoscopic enucleation of an esophageal leiomyoma. J Clin Gastroenterol. 2000;31:89.

    Article  CAS  Google Scholar 

  45. Boffa DJ, Dhamija A, Kosinski AS, Kim AW, Detterbeck FC, Mitchell JD, et al. Fewer complications result from a video-assisted approach to anatomic resection of clinical stage I lung cancer. J Thorac Cardiovasc Surg. 2014;148:637–43.

    Article  Google Scholar 

  46. Shigemura N, Yim AP. Variation in the approach to VATS Lobectomy: effect on the evaluation of surgical morbidity following VATS lobectomy for the treatment of stage I non–small cell lung cancer. Thorac Surg Clin. 2007;17:233–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anthony W. Kim .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 SAGES

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Thomas, D.C., Kim, A.W. (2019). Thoracoscopic Management of Benign Submucosal Tumors. In: Grams, J., Perry, K., Tavakkoli, A. (eds) The SAGES Manual of Foregut Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-96122-4_49

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-96122-4_49

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-96121-7

  • Online ISBN: 978-3-319-96122-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics