Comparison between submucosal tunneling endoscopic resection and video-assisted thoracoscopic surgery for large esophageal leiomyoma originating from the muscularis propria layer.
Submucosal tunneling endoscopic resection (STER) has been proved to be safe and effective for removal of esophageal leiomyoma originating from the muscularis propria (MP) layer. However, there are still technical challenges for tumors ≥35 mm due to the limited space of the submucosal tunnel. The aim of the study was to estimate the safety and efficacy of STER for large esophageal leiomyoma originating from the MP layer as well as compare its efficacy with video-assisted thoracoscopic surgery (VATS), which is a standard procedure for treating esophageal leiomyoma.



We retrospectively collected the clinical data of the patients with esophageal leiomyoma of 35-55 mm who underwent STER or VATS at our hospital between January 2010 and December 2014. Epidemiological data (gender, age), tumor location, tumor size, procedure-related parameters, complications, length of stay and cost were compared between STER and VATS.



A total of 31 patients were enrolled, and 18 patients underwent STER and the other 13 received VATS. There was no significant difference between the two groups in gender, age, tumor location, tumor size, complications and rate of en bloc resection (P > 0.05). However, patients in the STER groups had a shorter operation time, a less decrease in hemoglobin level, a shorter length of hospital stay and a decreased cost (P < 0.05). No recurrence was noted in the STER and VATS groups during a mean follow-up of 10.9 and 30.8 months, respectively.



The treatment efficacy was comparable between the STER and VATS for esophageal leiomyoma of 35-55 mm. However, STER is superior to VATS in a shorter operation time, a less decrease in hemoglobin level, a shorter length of hospital stay and a decreased cost.
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, NO. 139 RenMin Road, Changsha, 410011, Hunan, People's Republic of China.
Yuyong
Y
Tan
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, NO. 139 RenMin Road, Changsha, 410011, Hunan, People's Republic of China.
Liang
L
Lv
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, NO. 139 RenMin Road, Changsha, 410011, Hunan, People's Republic of China.
Tianying
T
Duan
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, NO. 139 RenMin Road, Changsha, 410011, Hunan, People's Republic of China.
Junfeng
J
Zhou
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, NO. 139 RenMin Road, Changsha, 410011, Hunan, People's Republic of China.
Dongzi
D
Peng
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, NO. 139 RenMin Road, Changsha, 410011, Hunan, People's Republic of China.
Yao
Y
Tang
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, NO. 139 RenMin Road, Changsha, 410011, Hunan, People's Republic of China. liudeliang@medmail.com.cn.
Deliang
D
Liu
D000328:Adult; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D061646:Operative Time; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D006454:Hemoglobins
Esophageal leiomyoma; Gastrointestinal surgical procedures; Submucosal tunneling endoscopic resection; Video-assisted thoracoscopic surgery