title: Minimally invasive resection of benign esophageal tumors.
abstract: OBJECTIVE
  Benign tumors of the esophagus are uncommon. Traditionally, resection has required thoracotomy or laparotomy. In this study we present our experience with resection of these tumors using a minimally invasive approach.
  
  
  METHODS
  A retrospective review of patients who underwent resection of benign esophageal tumors between 1990 and 2005 was conducted. Operative approach, tumor size, and outcomes after surgery were recorded.
  
  
  RESULTS
  Twenty patients were identified (leiomyoma: n = 15; stromal tumor: n = 3; granular cell tumor, n = 1; schwannoma: n = 1). Four patients underwent an open approach (right thoracotomy); the remainder were resected using minimally invasive techniques (thoracoscopy, n = 9; laparoscopy, n =7). There were no postoperative leaks or other major complications after surgery. Two patients required repair of a mucosal injury during resection. Mean tumor size in the open group was 8.1 cm (range 7-10 cm) compared with 3.5 cm (range 0.9-8 cm) in the minimally invasive group. Median length of stay was 5.5 days in the open group compared with 2.75 days in the minimally invasive group. Five patients subsequently required fundoplication for worsening (n = 3) or new-onset (n = 2) gastroesophageal reflux disease after tumor resection.
  
  
  CONCLUSIONS
  Minimally invasive resection of benign esophageal tumors is technically safe and associated with a shorter length of stay compared with open approaches. Although no specific cutoff for size could be identified, most tumors greater than 7 cm were removed by thoracotomy. The subsequent development of reflux may be related to the esophageal myotomy required for resection.
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Kent
authors.forename: Thomas
authors.initials: T
authors.lastname: d'Amato
authors.forename: Cory
authors.initials: C
authors.lastname: Nordman
authors.forename: Matthew
authors.initials: M
authors.lastname: Schuchert
authors.forename: Rodney
authors.initials: R
authors.lastname: Landreneau
authors.forename: Miguel
authors.initials: M
authors.lastname: Alvelo-Rivera
authors.forename: James
authors.initials: J
authors.lastname: Luketich
mesh_terms: D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000517:prevention & control; D016586:Granular Cell Tumor / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000601:surgery*; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000379:methods*; D013908:Thoracotomy / Q000379:methods