Clinical Outcomes of Minimally Invasive Enucleation of Leiomyoma of the Esophagus and Esophagogastric Junction

Objective Minimally invasive enucleation is the treatment of choice in symptomatic patients with esophageal leiomyoma. Comprehensive long-term follow-up data are lacking. Aim of this study was to review the clinical outcomes of three procedures for enucleation of leiomyoma of the esophagus and esoph...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2020-03, Vol.24 (3), p.499-504
Main Authors: Milito, Pamela, Asti, Emanuele, Aiolfi, Alberto, Zanghi, Simone, Siboni, Stefano, Bonavina, Luigi
Format: Article
Language:English
Subjects:
Clinical outcomes
Endoscopy
Esophageal cancer
Esophageal Neoplasms - surgery
Esophagogastric Junction - surgery
Esophagus
Fibroids
Gastroenterology
Gastroesophageal reflux
Gastrointestinal surgery
Humans
Leiomyoma - surgery
Medicine
Medicine & Public Health
Neoplasm Recurrence, Local
Original Article
Quality of Life
Retrospective Studies
Surgery
Treatment Outcome
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Summary:Objective Minimally invasive enucleation is the treatment of choice in symptomatic patients with esophageal leiomyoma. Comprehensive long-term follow-up data are lacking. Aim of this study was to review the clinical outcomes of three procedures for enucleation of leiomyoma of the esophagus and esophagogastric junction. Methods A single institution retrospective review was performed using a prospectively collected research database and individual medical records. Demographics, presenting symptoms, use of proton-pump inhibitors (PPI), tumor location and size, treatment modalities, and subjective and objective clinical outcomes were recorded. Barium swallow and upper gastrointestinal endoscopy were routinely performed during the follow-up. Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) and Short-Form 36 questionnaires were used to compare quality of life before and after treatment. Results Between 2002 and 2017, 35 patients underwent minimally invasive leiomyoma enucleation through thoracoscopy ( n  = 15), laparoscopy ( n  = 15), and endoscopy ( n  = 5). The overall morbidity rate was 14.3% and there was no mortality. All patients had a minimum of 1-year follow-up. The median follow-up was 49 (IQR 54) months, and there were no recurrences of leiomyoma. At the latest follow-up, the SF-36 scores were unchanged compared to baseline. However, there was a higher incidence of reflux symptoms ( p  
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-019-04210-3