title: Enucleation of submucosal tumors of the esophagus: minimally invasive versus open approach.
abstract: BACKGROUND
  Surgical enucleation of submucosal tumors (SMTs) of the esophagus (mostly leiomyomas) is indicated when either the tumors are symptomatic or their biological behavior is unclear. The classic approach is a thoracotomy, but tumor enucleation can now also be performed via thoracoscopy or, for distal tumors, via laparoscopy.
  
  
  METHODS
  We assessed our experience with the different approaches in a total of 25 patients (n = 13 minimally invasive approach and n = 12 open surgery). Enucleation of the SMT was the basic surgical principle; the choice of the approach was based on the preference of the surgeon.
  
  
  RESULTS
  Compared to open surgery, the minimally invasive approach reduced pulmonary complications, hospital stay, and postoperative wound-related pain. The operating time was the same for both approaches.
  
  
  CONCLUSIONS
  Minimally invasive approaches are suitable for the surgical enucleation of submucosal esophageal tumors. Thoracoscopic and laparoscopic techniques are recommended as standard procedures in experienced centers.
authors.affiliation: Department of Surgery, Technical University Munich, Ismaningerstrasse 22, 81675, Munich, Germany.
authors.forename: B H A
authors.initials: BH
authors.lastname: von Rahden
authors.forename: H J
authors.initials: HJ
authors.lastname: Stein
authors.forename: H
authors.initials: H
authors.lastname: Feussner
authors.forename: J R
authors.initials: JR
authors.lastname: Siewert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D008067:Lipoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000379:methods*; D013908:Thoracotomy; D014172:Transillumination; D016896:Treatment Outcome