Brief Reports
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2005; 11(27): 4258-4260
Published online Jul 21, 2005. doi: 10.3748/wjg.v11.i27.4258
Surgical treatment of giant esophageal leiomyoma
Bang-Chang Cheng, Sheng Chang, Zhi-Fu Mao, Mao-Jin Li, Jie Huang, Zhi-Wei Wang, Tu-Sheng Wang
Bang-Chang Cheng, Sheng Chang, Zhi-Fu Mao, Jie Huang, Zhi-Wei Wang, Tu-Sheng Wang, Department of Thoracic Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Mao-Jin Li, Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
Author contributions: All authors contributed equally to the work.
Supported by the Science and Technology Foundation of Hubei Province, No. 992P1203
Correspondence to: Professor Bang-Chang Cheng, Department of Thoracic Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China. dr_cheng@126.com Telephone: +86-27-88041919-2240
Received: December 25, 2004
Revised: January 6, 2005
Accepted: January 12, 2005
Published online: July 21, 2005
Abstract

AIM: To summarize the operative experiences for giant leiomyoma of esophagus.

METHODS: Eight cases of giant esophageal leiomyoma (GEL) whose tumors were bigger than 10 cm were treated surgically in our department from June 1980 to March 2004. All of these cases received barium swallow roentgenography and esophagoscopy. Leiomyoma located in upper thirds of the esophagus in one case, middle thirds of the esophagus in five cases, lower thirds of the esophagus in two cases. Resection of tumors was performed successfully in all of these cases. Operative methods included transthoracic extramucosal enucleation and buttressing the muscular defect with pedicled great omental flap (one case), esophagectomy and esophago-gastrostomy above the arch of aorta (three cases), total esophagectomy and esophageal replacement with colon (four cases). Histological examination confirmed that all of these cases were leiomyoma.

RESULTS: All of the eight patients recovered approvingly with no mortality and resumed normal diet after operation. Vomiting during meals occurred in one patient with esophagogastrostomy, and remained 1 mo. Reflux esophagitis occurred in one patient with esophago-gastrostomy and was alleviated with medication. Thoracic colon syndrome (TCS) occurred in one patient with colon replacement at 15 mo postoperatively. No recurrence occurred in follow-up from 6 mo to 8 years.

CONCLUSION: Surgical treatment for GEL is both safe and effective. The choices of operative methods mainly depend on the location and range of lesions. We prefer to treat GEL via esophagectomy combined with esophago-gastrostomy or esophagus replacement with colon. The long-time quality of life is better in the latter.

Keywords: Giant esophageal leiomyoma; Esophagus; Greater omentum; Esophageal replacement with colon