• GIST
• benign
• esophagus
• leiomyoma
• surgery
• tumor

• Efficacy and safety
• Giant esophageal leiomyoma
• Muscularis propria (MP) layer
• Piecemeal submucosal tunneling endoscopic resection (P-STER)

• Humans
• Leiomyoma/surgery
• Leiomyoma/pathology
• Female
• Middle Aged
• Esophageal Neoplasms/surgery
• Esophageal Neoplasms/pathology
• Retrospective Studies
• Male
• Endoscopic Mucosal Resection/methods
• Endoscopic Mucosal Resection/adverse effects
• Adult
• Length of Stay/statistics & numerical data
• Aged
• Esophagoscopy/methods
• Esophagoscopy/adverse effects
• Treatment Outcome
• Operative Time

• Endoscopic ultrasound (EUS)
• Epinephric diverticulum
• Esophageal leiomyoma

Background: Surgical treatment is usually suitable for patients with esophageal leiomyoma. Video-assisted thoracic surgery (VATS) offers a minimally invasive approach to thoracotomy. However, there is no clear conclusion on whether VATS can achieve an equal or even better surgical effect when compared with the traditional open approach in the treatment of esophageal leiomyoma. We performed this meta-analysis to explore and compare the outcomes of VATS vs. thoracotomy for patients with esophageal leiomyoma.

Methods: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Medline, and Web of Science databases were searched for full-text literature citations. The quality of the articles was evaluated using the Newcastle–Ottawa Scale and the data were analyzed using the Review Manager 5.3 software. Fixed or random effect models were applied according to heterogeneity.

Results: A total of 8 studies with 290 patients, of whom 141 patients were in the VATS group and 149 in the thoracotomy group, were involved in the analysis. Compared with thoracotomy, VATS was associated with shorter operative time, less blood loss in operation, and shorter postoperative hospital stay. There is no significant difference in postoperative pleural drainage day and postoperative complications between the two groups.

Conclusions: VATS has more advantages over thoracotomy, indicating that VATS is better than thoracotomy in terms of postoperative recovery. We look forward to more large-sample, high-quality studies published in the future.

• Sichuan Province Science and Technology Support Program

Benign esophageal tumors are rare accounting for < 1% of esophageal tumors; two-thirds of which are leiomyomas. Esophageal leiomyoma is a benign tumor derived from mesenchymal tissue that is completely muscularly differentiated. Most esophageal leiomyomas are < 5 cm. Esophageal leiomyomas > 5 cm are rare. We describe a case of a large esophageal leiomyoma involving the cardia and diaphragm.

A 35-year-old woman presented to the doctor because of a choking sensation after eating. Physical examination showed no positive signs. Gastroscopy indicated an uplifted change in the cardia. Enhanced computed tomography revealed space-occupying lesions in the lower part of the esophagus and cardia, which were likely to be malignant. Positron emission tomography–computed tomography showed increased metabolism of soft tissue masses in the lower esophagus and near the cardia. Malignant lesions were considered, and mesenchymal tumors were not excluded. Endoscopic ultrasonography was performed to examine a hypoechoic mass in the lower esophagus, which was unclear from the esophageal wall. Clinical evaluation suggested diagnosis of esophageal and cardiac stromal tumors. Finally, histological specimens obtained by endoscopic ultrasonography– fine needle aspiration suggested leiomyoma. The patient underwent laparoscopic local resection of the tumor. The postoperative pathological diagnosis was leiomyoma.

Endoscopic ultrasonography-fine needle aspiration is necessary for the diagnosis of gastrointestinal leiomyomas. It provides a strong basis for diagnosis of gastrointestinal tumors of unknown nature and origin.

• Esophageal tumor
• Leiomyoma
• Endoscopic ultrasonography
• Fine needle aspiration
• Endoscopic ultrasonography-fine needle aspiration
• Case report

• Esophageal leiomyoma
• Extra-mucosal enucleation
• Giant esophageal leiomyoma

• Adult
• Endoscopic Mucosal Resection/methods
• Esophageal Mucosa/surgery
• Esophageal Neoplasms/diagnostic imaging
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/surgery
• Esophagectomy/methods
• Feasibility Studies
• Humans
• Leiomyoma/diagnostic imaging
• Leiomyoma/pathology
• Leiomyoma/surgery
• Male
• Treatment Outcome
• Young Adult

Leiomyoma of the lower third of the esophagus is a relatively rare disorder but the most common benign tumor of the esophagus. We present a case of an involuted esophageal leiomyoma, 11 cm in size, treated by the laparoscopic approach. The preoperative computed tomogram visualized a mass 3 × 1.5 cm in diameter in the lower esophagus without an eccentric lumen or compression of nearby organs. Resection of the tumor was indicated according to the patient‘s symptoms and to exclude malignancy. Laparoscopic enucleation of esophageal leiomyoma was performed. The overall operative time was 205 min. The diagnosis of leiomyoma was established on histopathology and immunohistochemistry staining. The patient resumed the intake of a normal diet on the 5^th postoperative day and was discharged from hospital 8 days after the surgery. We have found this minimally invasive operation to be an effective and well-tolerated treatment option, determined by the experience of the surgeon.

• enucleation
• esophageal leiomyoma
• giant leiomyoma
• minimally invasive surgery

•

We report a case of esophageal leiomyoma enucleated by thoracoscopic procedures.

We report a relatively rare case of esophageal leiomyoma in the upper thoracic esophagus enucleated by thoracoscopic procedures. The usefulness of preoperative diagnosis and an adequate surgical approach are described along with a review of the relevant literature.

A submucosal tumor 45 mm in diameter was detected in the upper thoracic esophagus of a 69-year-old man. The tumor was preoperatively diagnosed from histopathological biopsy under endoscopic ultrasound-guided fine needle aspiration. Thoracoscopic enucleation was therefore preoperatively scheduled under the left decubitus position in consideration of the low risk of malignant disease. Histopathological diagnosis of the resected specimen was benign leiomyoma and patient outcomes were good.

The need for preoperative biopsy of esophageal submucosal tumor is a controversial issue. However, preoperative biopsy provided the benefits to decide the operative procedure or confirm adequate resection, and our experience suggested that preoperative biopsy did not adversely influence subsequent enucleation.

Precise preoperative diagnosis is necessary to avoid excessive surgery when managing esophageal submucosal tumor.

• Case report
• EUS-FNA
• Esophageal leiomyoma
• Thoracoscopic enucleation

Intramural esophageal tumors (IET) are located between unchanged mucous membrane and muscularis mucosae. They can be both benign and malignant.

To evaluate diagnostic and therapeutic difficulties of IET.

During the years 2010–2015, 11 patients with IET were treated in our clinic. Diagnostics included gastroscopy, computed tomography of the chest, endoscopic ultrasound (EUS) guided fine needle biopsy, and positron emission tomography (PET) of the esophagus in cases with no histopathological confirmation.

Based on the conducted analysis we diagnosed 1 case of gastrointestinal stromal tumor (GIST), 1 case of adenocarcinoma, and 2 cases of esophageal cysts. In another 7 cases radiological images resembled leiomyoma but with no histopathological confirmation. Esophagectomy was performed in 2 cases of malignant tumors and 1 case of a large benign tumor. In other cases surgical enucleation of tumors was performed. Postoperatively we diagnosed 6 cases of leiomyoma, 1 case of schwannoma, 2 esophageal cysts, 1 case of GIST and 1 of esophageal cancer.

Intramural esophageal tumors is a very diverse group of tumors, both malignant and benign. In every case of IET we should seek histopathological conformation. Treatment of IET depends on localization, size and histopathological type of lesion.

• diagnostics
• intramural esophageal tumors
• treatment

Esophageal leiomyoma is a relatively rare tumor of esophagus but it is the most common benign neoplasm of the esophagus. Small esophageal leiomyoma can be observed but larger ones and those producing symptoms should be excised. As observed for other esophageal tumors, dysphagia is its main symptom. Traditionally, open thoracotomy and enucleation are its main treatment but in the last few years video assisted thoracoscopic surgical (VATS) enucleation is gaining recognition with proven advantages of minimally invasive surgery. Herein we present our experience with patient presenting with cough rather than dysphagia as a main symptom, who was diagnosed to be having giant esophageal leiomyoma. VATS guided enucleation was accomplished successfully. Size of lesion was 16 × 4 × 3 cm. Postoperative recovery was uneventful and patient is not having any signs of recurrence, after three years during follow-up period.

• helicobacter pylori
• eradication
• benign gastric ulcer
• recurrence

• Adult
• Aged
• Anti-Bacterial Agents
• Drug Therapy, Combination/therapeutic use
• Female
• Follow-Up Studies
• Helicobacter Infections/complications
• Helicobacter Infections/drug therapy
• Helicobacter pylori
• Humans
• Male
• Middle Aged
• Recurrence
• Stomach Ulcer/etiology
• Time Factors