Onodera Y, Nakano T, Takeyama D, Maruyama S, Taniyama Y, Sakurai T, Heishi T, Sato C, Kumagai T, Kamei T. Combined thoracoscopic and endoscopic surgery for a large esophageal schwannoma. World J Gastroenterol 2017; 23(46): 8256-8260 [PMID: PMC5739932 DOI: 10.3748/wjg.v23.i46.8256]
Corresponding Author of This Article
Toru Nakano, MD, PhD, Associate professor, Division of Gastroenterological and Hepatobiliarypancreatic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai Miyagi 983-8560, Japan. torun@med.tohoku.ac.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yu Onodera, Shota Maruyama, Yusuke Taniyama, Tadashi Sakurai, Takahiro Heishi, Takuro Kumagai, Chiaki Sato and Takashi Kamei, Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai Miyagi 980-8574, Japan
Toru Nakano, Daisuke Takeyama, Division of Gastroenterological and Hepatobiliarypancreatic Surgery, Tohoku Medical and Pharmaceutical University, Miyagino-ku, Sendai Miyagi 983-8560, Japan
Author contributions: Onodera Y is the first author and Nakano T is the correspondence author; Nakano T designed the study and planed the managements; Nakano T, Takeyama D and Kumagai T were operators of the thocoscopic procedure; Mruyama S was the operator of the endoscopic procedure; Onodera Y, Takeyama D, Taniyama Y, Sakurai T, Heishi T, Kumagai T and Kamei T were attending doctors and provided all treatment including the surgical operation; all authors agree with the content of the manuscript and the roles that are specifically attributed to them.
Supported by (partially) JSPS KAKENHI, No. JP15K15487.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: All authors have no conflict-of-interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Toru Nakano, MD, PhD, Associate professor, Division of Gastroenterological and Hepatobiliarypancreatic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai Miyagi 983-8560, Japan. torun@med.tohoku.ac.jp
Telephone: +81-22-2591221 Fax: +81-22-2591231
Received: June 25, 2017 Peer-review started: June 28, 2017 First decision: July 13, 2017 Revised: August 23, 2017 Accepted: September 13, 2017 Article in press: September 13, 2017 Published online: December 14, 2017 Processing time: 169 Days and 16.6 Hours
Abstract
A 47-year-old woman presented to our hospital with complaints of dysphagia. Esophagogastroduodenoscopy identified a submucosal tumor in the left wall of the esophagus that was diagnosed as a benign schwannoma on biopsy. Computed tomography revealed a tumor of length 60 mm in the thoracic esophagus, with its cranial edge at the level of the aortic arch. On endoscopy, a submucosal tunnel was created 40 mm proximal to the cranial edge of the tumor, and its oral end was dissected from the mucosal and muscular layers. This was followed by the resection of the entire tumor by left-sided thoracoscopy. The esophageal defect was closed in layer by continuous suture from the thoracic side. Endoscopic closure was achieved by using clips. No postoperative complications were observed. Oral diet was resumed from postoperative day 7 and the patient was discharged on postoperative day 9. This combined approach has not been described for similar tumors. Our experience demonstrated that large esophageal tumors can be safely excised with minimally invasive surgery by using a combination of thoracoscopy and endoscopy.
Core tip: A 47-year-old woman was diagnosed with a benign schwannoma of length 60 mm in the thoracic esophagus. On endoscopy, a submucosal tunnel was created 40 mm proximal to the cranial edge of the tumor, and its only oral end was dissected from the mucosal and muscular layers. This was followed by the resection of the entire tumor by left-sided thoracoscopic procedure. Endoscopic closure was achieved by using clips. No postoperative complications were observed. Our experience demonstrated that large esophageal tumors can be safely excised with minimally invasive surgery by using a combination of thoracoscopy and endoscopy.
