An esophageal GIST diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy and treated by thoracoscopic enucleation Osamu SAJI 1 , Shinya MIKAMI 1 , Takeharu ENOMOTO 1 , Natsuko SASAKI 1 , Kazuya NIWA 1 , Takehito OTSUBO 1 1Department of Gastrointestinal and General Surgery, St. Marianna University School of Medicine Keyword: 食道GIST , 胸腔鏡下手術 , 核出術 pp.355-362
Published Date 2017/5/15
DOI https://doi.org/10.11477/mf.4426200411
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We describe diagnosis and treatment of a low-risk esophageal gastrointestinal stromal tumor(GIST) that was identified during a positron emission tomography health screening and remedied by means of thoracoscopic enucleation. The patient was placed in the left semiprone position, and one-lung ventilation and artificial pneumothorax were established. Under endoscopic guidance, hyaluronic acid with indigo carmine was injected into the submucosa immediately beneath the tumor. The tumor was then approached thoracoscopically via three ports, the esophageal adventitia and muscular layer were incised and dissected, and the tumor was enucleated. Pathological examination revealed a very low grade 16×14-mm GIST. The postoperative course was uneventful, and the patient was discharged on postoperative day 10. One year has passed, and there have been no signs of recurrence. We believe that thoracoscopic enucleation is a useful treatment for low-risk esophageal GIST. In addition, preoperative endoscopic ultrasound-guided fine-needle aspiration biopsy should be performed whenever possible for the purpose of deciding on a suitable surgical technique.

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