Phẫu thuật nội soi bóc u cơ thực quản lành tính tại Bệnh viện Đại học Y Hà Nội

Abstract

The retrospective study was conducted to evaluate the effectiveness of enucleation thoracoscopic and laparoscopic for esophageal leiomyoma. 36 patients were treated using thoracoscopic and laparoscopic esophageal leiomyomas enucleation at Hanoi Medical University Hospital from 2016 to 2020. The mean age was 50.4 (range 24 - 78 years). Male/Female sex ratio was 2.6:1. Twenty - nine patients had clinical symptoms (80.6%), and the remaining seven (19.4%) were asymptomatic. Tumors were identified in the upper third (8.3%), middle third (30.6%), and lower third (61.1%) of the esophagus. Mean tumor size was 2.9 cm (range 1.8 - 6.0 cm). Laparoscopic enucleation was performed on 17 patients who had leiomyoma located near the cardia (gastroesophageal junction or abdominal esophagus). The remaining 19 patients underwent right thoracoscopic enucleation. Three to five ports were used to perform the procedures. No major perioperative surgical or medical complications were reported. The median operative time was 107 minutes in thoracoscopic enucleation and 137 minutes in laparoscopic enucleation. The mean duration of hospital stay was 7.4 days (range 4 - 12 days). In conclusion, thoracoscopic and laparoscopic enucleation of esophageal leiomyoma is technically safe and associated with a high therapeutic success and low medico - surgical morbidity rates. Thoracoscopic enucleation could be applied for almost all esophageal leiomyoma tumors. Laparoscopic approach should be performed for tumors located near the gastroesophageal junction in order to create an anti - reflux valve after enucleation.