Thoracoscopic enucleation of a large spiral esophageal leiomyoma using a pre-tied loop ligature (Endoloop)

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  • エンドループを利用して胸腔鏡下核出術を施行した巨大食道平滑筋腫の一例

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Thoracoscopic enucleation has been first choice for surgical treatment of esophageal benign submucosal tumors (SMTs). However, intraoperative perforation of the esophagus can sometimes occur, causing serious complications. The risk is especially high for large or annular tumors, as they are difficult to grasp sufficiently well during thoracoscopic instrumentation, and this tends to hinder identification of the correct dissection plane. Therefore, for tumors more than 5 cm diameter, open thoracotomy is generally recommended. Here we describe a large spiral leiomyoma of the esophagus that was successfully enucleated by thoracoscopic surgery using a pre-tied loop ligature (Endoloop). Endoloop was very useful for grasping and pulling up the large tumor, and we were easily able to achieveadjustable countertraction for accurate and safe dissection of the tumor from the submucosal layer of the esophageal wall.

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