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Submucosal tunneling endoscopic resection (STER) with full-thickness muscle excision for a recurrent para-aortic esophageal leiomyoma after surgery.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Donatelli, Gianfranco Fuks, David Pourcher, Guillaume Dumontier, Isabelle Cereatti, Fabrizio Perniceni, Thierry Gayet, Brice |
| Copyright Year | 2017 |
| Abstract | We report the case of a 49-year-old woman with a recurrent esophageal leiomyoma following two surgical resections. The surgical procedures had been performed 23 and 21 years previously. Follow-up showed lesion recurrence in the mid esophagus (▶Fig. 1 and ▶Fig. 2). Submucosal endoscopic tunneling resection (STER) was preferred to surgery because of the previous interventions. A single shot of 2 g ceftriaxone was administered intravenously prior to the procedure. Submucosal injection, mucosal incision, and tunnel creation was started 5 cm above the lesion. Enucleation was performed using a DualKnife J (Olympus, Tokyo, Japan). The lesion was close to the aorta, so the final dissection was carried out by synchronizing with aortic movements. Full-thickness muscle resection was required to achieve en bloc resection being careful to preserve the esophageal adventitia (▶Video1). The leiomyoma was grasped with a 30-mm snare and was easily removed (▶Fig. 3). Six standard clips (QuickClip Pro; Olympus) were deployed to close the mucosal incision. A computed tomography (CT) scan with swallow study was performed on postoperative day 1; oral diet was restarted on day 2. Histological examination did not show any malignancy. Tumors originating from the muscularis propria require surgery in most cases [1]. STER is a novel approach for the treatment of subepithelial tumors of the gastrointestinal tract. The risk of perforation may reach up to 15% [2]. If the tumor develops from the muscularis propria, preservation of the serosal layer is difficult; circumferential incision of the serosa is therefore often required to complete en bloc resection [3]. Even though a large muscular defect exists, mediastinitis does not occur if the mucosal continuity is maintained [4]. Recurrent esophageal leiomyoma has been anecdotally reported and is usually related to incomplete resection or enlargement of a previously undetected nodule [5]. Here, we report the first STER treatment for recurrent esophageal |
| Starting Page | E86 |
| Ending Page | E87 |
| Page Count | 1 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0043-100212.pdf |
| PubMed reference number | 28192801v1 |
| Alternate Webpage(s) | https://doi.org/10.1055/s-0043-100212 |
| DOI | 10.1055/s-0043-100212 |
| Journal | Endoscopy |
| Volume Number | 49 |
| Issue Number | 01 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Aorta Atrial Septal Defects Ceftriaxone Circumference Endoscopic Retrograde Cholangiopancreatography Esophageal Leiomyoma Esophageal Neoplasms Esophageal spasm Esophagus Excision Fibroid Tumor Gastrointestinal tract structure Hypertrophy Mediastinitis Medical Device Material Perforation Mucous Membrane Muscle layer Nodule Operative Surgical Procedures Pituitary Neoplasms SNAP receptor Serous Membrane Surgical incisions X-Ray Computed Tomography myectomy removal technique |
| Content Type | Text |
| Resource Type | Article |
