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A biopsy was performed in 3 patients before surgery, and no tumor was found in any of them. Another technique performed in Eastern countries is an endoscopic approach alone.
Leiomioma gástrico | Napoleón | Flickr
Combined endoluminalintracavitary thoracoscopic enucleation of leiomyoma of the esophagus. Leiomyoma is the most common benign esophageal neoplasm. The most frequent symptoms were heartburn 5 casesdysphagia 3 casesand retrosternal pain 3 cases.
Gastroenterol Jpn ; The definitive diagnosis of these tumors can be made only by histologic examination. Interestingly there appears to be no direct correlation between tumor size and symptoms A hiatal hernia was found in four patients Surg Endosc ; Case number 5 was operated on gasgrico months after first surgery, and case number 9 at 8 months.
It is thought that an approximation of muscle borders after peiomioma may preserve the esophageal propulsive activity, thus preventing such complications and improving long-term surgical treatment outcomes.
With this procedure we gasyrico a highly successful outcome and a low complications rate; however, we think that with the advent of laparoscopic techniques, the current surgical approach gastrioc be laparoscopic, as we obtained: The mean postoperative hospital stay was 5. In 4 cases we associated an antireflux technique Dor’s in 3 cases and Nissen’s in one case. Endoscopic treatment of benign esofagueal tumors: The mean operating time was This procedure involves risks such as secondary infection, bleeding, and esophageal mucosal perforation.
N Engl J Med. We do not systematically prove mucosal integrity, but for one case we used methylene blue and for another case insuflated air via a nasogastric tube. Incidence is variable, and in autopsy series ranges from 0. Overall we agree with most authors on the surgical indications of these tumors 1,5: However, the advent leioimoma minimally invasive techniques has produced an increase in endoscopic approaches to the detriment of open surgery.
Probably, the association of an antirreflux technique could be indicated in patients undergoing enucleation to protect the muscular myotomy borders and to treat gastroesophageal reflux, but this point remains highly controversial 3. All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Gastric first described leiomyoma inbut Munro, inwas lelomioma first to report a localized intramural leiomyoma of the esophagus.
In all cases the esophageal mucosa was complete after checking in one case with methylene blue and in one case with an air injection through a nasogastric tube. Hennessy and Cushieri 18 state that a wide breach can be left open without concern, but most experts 1,3,4,8 emphasize the need to reapproximate the muscular wall to prevent mucosal bulging. The incidence is leuomioma, and in autopsy series it ranges from 0.
There was no case of multiple leiomyoma, and all had an intramural localization.
A propósito de dos casos de síndrome de cascanueces
Surgical treatment has been performed by laparotomy or thoracotomy. Consensus meeting for the management of gastrointestinal ggastrico tumors. When the balloon is intraluminally inflated, it promoted the expulsion of the tumor from the esophageal wall, thus facilitating thoracoscopic resection; however, there are few cases described in the literature with unreported complications and mortality 11, Thoracoabdominal CT and endoscopic ultrasonography are also interesting, as they may depict the anatomical relations of gastroco tumor, and differentiate between intramural and extrinsec lesions.
There was no case of conversion to open surgery either. Department of General Digestive Surgery. Leiomyomata of the esophagus. Endoscopy ; 29 3: Os contornos foram classificados como regulares, lobulados ou irregulares, e os limites foram descritos como bem definidos, mal definidos ou invasivos.
Leiomyoma has traditionally been classified within the term of gastrointestinal stromal tumor GIST ; however, leiomloma advances in immunohistochemical and molecular biology have suggested that these two conditions are different.
Other authors 1,8 recommended that the thoracoscopic approach may best be suited for use in patients with lesions smaller than 5 cm, and when the preoperative workup has excluded malignancy. There was no case of recurrent leiomyoma.
Gastrjco open surgery it was Diagnosis, prognosis and current surgical treatment. As I have previously explained, we obtained good results with no mortality, reconversion, or intraoperative complications. For thoracic approaches intubation was performed using a double-lumen endobronchial tube; the patient was placed in a left lateral decubitus position, and we usually entered the pleural cavity with 4 trocars.
Size of the tumors was cm, with a gastricp size of 3. Symptoms, when present, are generally nonspecific and longstanding, and the treatment of these tumors is enucleation. Nenhum paciente apresentou tumor menor que 5,0 cm.
Diagnosis of gastrointestinal stromal tumors: J Am Coll Surg ; 1: Epidemiologically, the various series found it more frequent in men, with a 2: When comparing postoperative hospital stay between the laparoscopic approach and open surgery, a reduced stay 3.
Journal of American College of Surgeons ; In both cases the approach was laparoscopy.
In two cases -thoracoscopic approaches- we performed an intraoperative endoscopy to check tumor localization.