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ORIGINAL ARTICLE
Ahead of Print

Thoracoscopic enucleation of oesophageal submucosal tumours in prone position gives excellent long-term outcome: A single-centre experience


 Department of Surgical Gastroenterology and Minimal Invasive Surgery, Santokba Durlabhji Memorial Hospital and Medical Research Centre, Santokba Institute of Digestive Surgical Sciences, Jaipur, Rajasthan, India

Correspondence Address:
Rajesh Bhojwani,
Santokba Institute of Digestive Surgical Sciences, Santokba Durlabhji Memorial Hospital, Jaipur - 302 015, Rajasthan
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.jmas_169_21

Background: Thoracoscopic enucleation of oesophageal leiomyomas has been adopted by many centres. The procedure when performed in prone position gives good results. The long-term outcome has not been reported earlier. This single-centre study establishes the role of this particular technique. Methods: A retrospective analysis of a prospectively maintained hospital database was performed and after following the study criteria eleven cases of oesophageal submucosal tumours were included in the study. All patients underwent thoracoscopic enucleation in the prone position by a single surgeon. Peri-operative data were recorded and patients followed up for a mean period of 78 months (range = 24–120 months). Results: Thoracoscopic enucleation in prone position was done for all patients with no conversions to an open procedure. Two patients had a mucosal rent during dissection that was repaired. There was no post-operative morbidity greater than Clavien-Dindo Grade 2. Long-term follow-up is available for eight patients (73%) with no recurrence of disease or symptoms. Conclusion: Oesophageal submucosal tumours (predominantly leiomyomas) are benign neoplasms with an indolent biological behaviour and deserve a procedure that would serve the purpose of minimal post-operative morbidity coupled with excellent outcome. Thoracoscopic enucleation in the prone position provides a physiological benefit that translates into better peri-operative outcomes without compromising the long-term outcome and should be the preferred form of treatment for oesophageal submucosal tumours.


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    -  Mishra S
    -  Jain N
    -  Soni B
    -  Bajaj D
    -  Khetan A
    -  Sharma B
    -  Bhojwani R
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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04