Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary Hospital

BackgroundEsophageal leiomyoma is the most common benign tumor in the esophagus. Thoracotomy and thoracoscopy are both elective for esophageal leiomyoma enucleation. This study aimed at presenting surgical experience in our center and exploring more suitable surgical methods for different situations...

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Main Authors: Gu-Ha A-Lai, Jian-Rong Hu, Peng Yao, Yi-Dan Lin
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-04-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2022.876277/full
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author Gu-Ha A-Lai
Jian-Rong Hu
Peng Yao
Yi-Dan Lin
author_facet Gu-Ha A-Lai
Jian-Rong Hu
Peng Yao
Yi-Dan Lin
author_sort Gu-Ha A-Lai
collection DOAJ
description BackgroundEsophageal leiomyoma is the most common benign tumor in the esophagus. Thoracotomy and thoracoscopy are both elective for esophageal leiomyoma enucleation. This study aimed at presenting surgical experience in our center and exploring more suitable surgical methods for different situations.MethodsWe conducted this retrospective study by collecting data from patients who underwent esophageal leiomyoma enucleation through thoracotomy or thoracoscopy from January 2009 to November 2021 at West China Hospital Sichuan University.ResultsA total of 34 patients were enrolled for analysis. All patients were diagnosed with a single esophageal leiomyoma. There were 25 men and 9 women. The mean age was 44.41 years (range, 18–72 years), the mean longest diameter was 4.99 cm (range, 1.4–10 cm), and the esophagus was thoroughly circled with leiomyoma in 10 patients, 10 patients underwent thoracotomy to enucleate leiomyoma, while others underwent thoracoscopic enucleation. No perioperative deaths occurred. Between the thoracotomy group and thoracoscopy group, baseline characteristics were comparable except for gastric tube status (p = 0.034). Patients were inclined to undergo the left lateral surgery approach (p = 0.001) and suffered esophagus completely encircled by leiomyoma (p = 0.002). Multivariable logistic regression analysis demonstrated that the left lateral surgery approach (p = 0.014) and esophagus completely encircled by leiomyoma (p = 0.042) were risk factors for thoracotomy of leiomyoma enucleation, while a larger tumor size demonstrated no risk. The median follow-up time was 63.5 months, and no deaths or recurrence occurred during the follow-up period.ConclusionThoracotomy enucleation of the leiomyoma was recommended when the esophagus was thoroughly encircled by the leiomyoma and the left lateral surgery approach was needed. However, tumor size demonstrated less value for selecting a surgical approach.
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spelling doaj.art-9146f191ce994596bc2b5ba699a3d8f12022-12-22T01:46:21ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-04-011210.3389/fonc.2022.876277876277Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary HospitalGu-Ha A-Lai0Jian-Rong Hu1Peng Yao2Yi-Dan Lin3Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaOperating Room of Anesthesia Surgery Center, West China Hospital/West China School of Nursing, Chengdu, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, ChinaBackgroundEsophageal leiomyoma is the most common benign tumor in the esophagus. Thoracotomy and thoracoscopy are both elective for esophageal leiomyoma enucleation. This study aimed at presenting surgical experience in our center and exploring more suitable surgical methods for different situations.MethodsWe conducted this retrospective study by collecting data from patients who underwent esophageal leiomyoma enucleation through thoracotomy or thoracoscopy from January 2009 to November 2021 at West China Hospital Sichuan University.ResultsA total of 34 patients were enrolled for analysis. All patients were diagnosed with a single esophageal leiomyoma. There were 25 men and 9 women. The mean age was 44.41 years (range, 18–72 years), the mean longest diameter was 4.99 cm (range, 1.4–10 cm), and the esophagus was thoroughly circled with leiomyoma in 10 patients, 10 patients underwent thoracotomy to enucleate leiomyoma, while others underwent thoracoscopic enucleation. No perioperative deaths occurred. Between the thoracotomy group and thoracoscopy group, baseline characteristics were comparable except for gastric tube status (p = 0.034). Patients were inclined to undergo the left lateral surgery approach (p = 0.001) and suffered esophagus completely encircled by leiomyoma (p = 0.002). Multivariable logistic regression analysis demonstrated that the left lateral surgery approach (p = 0.014) and esophagus completely encircled by leiomyoma (p = 0.042) were risk factors for thoracotomy of leiomyoma enucleation, while a larger tumor size demonstrated no risk. The median follow-up time was 63.5 months, and no deaths or recurrence occurred during the follow-up period.ConclusionThoracotomy enucleation of the leiomyoma was recommended when the esophagus was thoroughly encircled by the leiomyoma and the left lateral surgery approach was needed. However, tumor size demonstrated less value for selecting a surgical approach.https://www.frontiersin.org/articles/10.3389/fonc.2022.876277/fullesophagusleiomyomaenucleationthoracotomythoracoscopy
spellingShingle Gu-Ha A-Lai
Jian-Rong Hu
Peng Yao
Yi-Dan Lin
Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary Hospital
Frontiers in Oncology
esophagus
leiomyoma
enucleation
thoracotomy
thoracoscopy
title Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary Hospital
title_full Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary Hospital
title_fullStr Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary Hospital
title_full_unstemmed Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary Hospital
title_short Surgical Treatment for Esophageal Leiomyoma: 13 Years of Experience in a High-Volume Tertiary Hospital
title_sort surgical treatment for esophageal leiomyoma 13 years of experience in a high volume tertiary hospital
topic esophagus
leiomyoma
enucleation
thoracotomy
thoracoscopy
url https://www.frontiersin.org/articles/10.3389/fonc.2022.876277/full
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AT jianronghu surgicaltreatmentforesophagealleiomyoma13yearsofexperienceinahighvolumetertiaryhospital
AT pengyao surgicaltreatmentforesophagealleiomyoma13yearsofexperienceinahighvolumetertiaryhospital
AT yidanlin surgicaltreatmentforesophagealleiomyoma13yearsofexperienceinahighvolumetertiaryhospital