A case of thoracoscopic enucleation for a large esophageal submucosal tumor using endoscopic local injection to the submucosal layer Yuko KAMATA 1 , Toshiro TANIOKA 1 , Shigeo HARUKI 2 , Kyoko RYU 1 , Satoshi MATSUI 1 , Koji ITO 1 1Department of Gastroenterological Surgery, Tsuchiura Kyodo General Hospital 2Department of Esophageal Surgery, Tokyo Metropolitan Cancer and Infectious Center Komagome Hospital Keyword: 食道粘膜下腫瘍 , 胸腔鏡下手術 , 核出術 pp.383-389
Published Date 2021/9/15
DOI https://doi.org/10.11477/mf.4426200936
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 A 41-year-old man underwent esophagography during a medical examination and was found to have a 6-cm large esophageal submucosal tumor(SMT). The tumor was located on the anterior aspect of the middle thoracic esophagus, and leiomyoma or schwannoma was suspected. Although the tumor was large, we performed thoracoscopic enucleation to preserve esophageal function. During the operation, it was difficult to distinguish the tumor from the mucosa; therefore, we performed a local injection in the submucosal layer with an upper gastrointestinal endoscope. The resected specimen was a 7.5×3.0×1.5-cm solid tumor diagnosed as a leiomyoma. No postoperative complications were found. Thoracoscopic enucleation for esophageal SMTs is common; however, it is difficult to prevent intraoperative injuries during surgical manipulations of large tumors. We managed to resect a large SMT using a local injection to the submucosal layer, which is similar to the endoscopic submucosal dissection technique. This technique would be suitable for large esophageal SMT, because it allows for the tumor to be resected easily and safely.

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