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Clinicopathological characteristics and outcomes of esophageal submucosal tumors upon treatment by thoracoscopic enucleation or endoscopic follow up alone

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Abstract

Background

We compared the clinicopathological features and outcomes of patients with submucosal tumor (SMT) of the thoracic esophagus treated by thoracoscopic enucleation.

Methods

Of 11 patients with endoscopically detected SMTs in the thoracic esophagus, 6 underwent thoracoscopic enucleation and were endoscopically followed up.

Results

The thoracoscopically enucleated tumors were 3 leiomyomas, 2 schwannomas, and 1 gastrointestinal stromal tumor. Five tumors were not removed surgically but showed no enlargement over 3 years (range 42–84 months); 4 of these tumors were histologically diagnosed as leiomyomas by fine-needle aspiration analysis or routine biopsy. All patients who underwent thoracoscopic enucleation had dietary symptoms preoperatively, whereas those who did not undergo it were asymptomatic. Tumor size ranged from 30 to 45 mm for the surgical cases. In cases in which preoperative endoscopic biopsy was performed, the tumors were found to be adherent to the esophageal mucosa during enucleation surgery; however, neither mucosal injury nor postoperative leakage occurred. SMTs not treated by thoracoscopic enucleation were <15 mm in diameter and showed no enlargement over a long-term follow-up period. No differences in clinical features, excluding schwannoma and GIST, were noted between cases with and without therapeutic enucleation.

Conclusion

Thoracoscopic enucleation is useful and safe for the removal of thoracic esophageal SMTs ranging from 30 to 50 mm in diameter. Leiomyomas of the thoracic esophagus <20 mm in diameter may be followed up endoscopically in asymptomatic cases.

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Ethical Statement

This article does not contain any studies with human or animal subjects performed by any authors.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan

    Satoshi Sugiyama, Naohiko Koide, Daisuke Takeuchi, Akira Suzuki & Shinichi Miyagawa

  2. Department of Surgery, Nagano Prefectural Kiso Hospital, Nagano, Japan

    Naohiko Koide

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  1. Satoshi Sugiyama
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  2. Naohiko Koide
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  3. Daisuke Takeuchi
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  4. Akira Suzuki
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  5. Shinichi Miyagawa
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Correspondence to Satoshi Sugiyama.

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Sugiyama, S., Koide, N., Takeuchi, D. et al. Clinicopathological characteristics and outcomes of esophageal submucosal tumors upon treatment by thoracoscopic enucleation or endoscopic follow up alone. Esophagus 12, 31–37 (2015). https://doi.org/10.1007/s10388-014-0446-4

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  • DOI: https://doi.org/10.1007/s10388-014-0446-4

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