A Clinical Study On33Cases Of Esophageal Leiomyoma Resection By Thoracoscopy Or Laparoscopy

Objective: Leiomyoma is the most common mesenchymal tumor of theesophagus，accounts for about70%of all esophageal benign tumor，relymainly on the surgical treatment，and minimally invasive surgery is thedevelopment trend of surgery. This article analyzed the clinical data of33esophageal leiomyoma patients which were treated，to explore the treatment ofesophageal leiomyoma by thoracoscopy or laparoscopy and analysis itsexperience.Methods:The clinical data of33patients with esophageal leiomyomawho were treated by thoracoscopy or laparoscopy in our department fromJanuary2010to February2014were collected retrospectively,20cases ofmen and13cases of women, ages from31to63years, with an average age of48.5years. All patients were divided into3groups (A, B, C), by operationsuccessively in turn,11cases in each group, All surgeries were made by thesame operation group. Using multiple independent samples nonparametric testof statistical method, to analyze the operating time, blood loss, conversion rateinto open surgery, post-operative complications, postoperative chest tubedrainage and hospital stay, to investigate the effect of endoscopic surgicaltreatment of esophageal leiomyoma and summarize the successful experience.Results: In the group, complete the full endoscopic in29cases, including25cases of thoracoscopy,4cases of laparoscopy,4cases underwentthoracotomy or laparotomy,4cases’ esophageal mucosa were broken duringthe surgery, both were repaired. All cases have no operative mortality andrecurrence. The operation time in group A(135±40) min，group B(92±36)min,group C(85±56)min, P<0.05,the operation time reduce in turn, wasstatistically significantly. The drainage time in group A (4.2±1.6)d, groupB(3.2±2.1)d, group C(2.9±1.3)d, P<0.05, the drainage time reduce in turn, was statistically significantly. The postoperative hospital stay in group A (7.5±2.9)d，group B (5.6±1.9)d，group C (5.5±1.1)d，P<0.05，the postoperativehospital stay reduce in turn, was statistically significantly. No difference wasfound in the age,the blood loss and the fasting time (P>0.05).Patients werefollowed up1to18months, there’s no complication like esophageal fistula,scar stenosis, esophageal diverticulum and so on.Conclusion:1. Esophageal leiomyoma resected by thoracoscopy or laparoscopyconforms to the principle of minimally invasive treatment, and the treatmenteffect is certainly，worth promoting.2. The indication of turn open surgery, should be grasp rationally，thepatients whose leiomyoma are difficult to be resected, should be turn to theopen surgery in time, in order to avoid causing more complications.3. In the beginning to perform leiomyoma resection by thoracoscopy orlaparoscopy, the surgeon should choose these patients with typical leiomyomaand operation is not too difficult.