Esophageal Leiomyoma Treatment
Although Esophageal Leiomyoma is benign disease, but the possibility of malignant transformation potential. Generally slow-growing, but the lesions continue to progress, the larger oppression of surrounding tissue may produce a series of complications. Therefore, once confirm diagnosed, should surgical treatment for Esophageal Leiomyoma.
The choice of incision：determine surgical incision base on the tumor location. It should perform X-ray positioning tests. Polypoid leiomyoma pedicle in the cervical esophagus and more, check oblique incision pharynx or neck; located in the upper esophagus outside line before or after the right lateral incision; in the next paragraph from the left or right posterolateral thoracotomy incision.
Surgical: mucosal tumor removal. No preoperative lateral hole (the gastric side-hole distal segment cut off) tube. After thoracotomy in accordance with pre-operative X-ray examination to understand the location, in the vicinity of the free esophageal tumor, palpable to the masses, the esophagus to the scallops lightly with pull-out from the mediastinum, the uplift in the tumor, that is thinner muscularis, the direction of muscle fiber blunt Shun separate longitudinal muscle exposed tumor. Found along the interface of tumor after careful separation of the outer membrane, to avoid mucosal injury. After removal of the tumor, such as suspected of having mucosal injury to the gastric pull-side surgery, the use of their upper and lower side band temporarily blocked esophagus, intrathoracic injection of warm saline, and then into the air by the tube to check for leakage. If damaged, repair with fine needle thread, guitar playing in the cavity. Separate the outer muscular layer suture osteoporosis, such as the muscle has a very thin, can be used near the mediastinal pleura, pericardium, or diaphragm suture reinforcement piece and, if necessary, can be covered free intercostal muscle. Larger defects, can repair by terylen patch, in order to avoid the formation of postoperative diverticulum. Larger tumors may free long esophagus, esophageal necrosis does not occur in general, more than 10cm is still free to resume good.
A few patients with Esophageal Leiomyoma should remove part of esophagus and stomach, the indications are as follows:
Esophageal Leiomyoma treatment with mucosal tumor removal have good effect, and less complications, almost no postoperative recurrence and esophageal stricture or swallowing obstruction.