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PubMed2004

[Esophageal leiomyoma enucleated under the thoracoscopy; report of a case].

We report a case of a 40-year-old male with a posterior mediastinal mass that was 8 cm in size and located behind the trachea. The thoracoscopic surgery was performed. The tumor was located from the level of left brachiocephalic vein to the carina. The mediastinal pleura over the tumor was longitudinally opened by cautery-scissors. The azygos vein lying over the tumor was divided by means of an endoscopic stapler. The muscular layer of the esophagus was also longitudinally opened. The tumor was enucleated. Then, the dissected proper muscle layer of the esophagus was suture-closed. The postoperative course was uneventful. On the first postoperative day Gastrografin was swallowed, showing the absence of leaks. The patient was discharged on the fourth postoperative day. The advantages of the thoracoscopic surgery are as follows: rapid, full recovery of the patient; decreased postoperative pain; short postoperative hospital stay. Esophageal leiomyoma in selected patient was suitable for thoracoscopic enucleation.

Adult↗
PubMed2005

[Esophageal operations with thoracoscopy].

Between 01.07.1992 and 30.06.1997 we performed thoracoscopic esophagomyotomies in seven patients suffering from achalasia cardiae, and 6 thoracoscopic mobilization of the esophagus because of esophageal cancer. The necessary background for thoracoscopic operations are: practice in minimally invasive surgery, isolated intubation, appropriate instrumentation and readiness for immediate thoracotomy. Following the myotomy, oral feeding started on the 2nd postoperative day. The mean discharge of the patients was on the 6th postoperative day. We compared the pre- and post-operative conditions 6 weeks following the operation x-ray, esophago-gastroscopy, manometry, pH-measurements were performed. Good result of the operations were: all examinations showed marked improvement and all patients had better swallowing and 3 to 9 kg increase of body weight. Thoracoscopic mobilization has been attempted on nine occasions. Thoracotomy was necessary in 3 patients because of a perforation of the left main bronchus, bleeding and tumor infiltration to surrounding areas. The mean mobilization time was 4 hours, but the time original 6 hours with practice was reduced to less than 3 hours. One patient died because of pulmonary complication, recovery of other patients was uneventful.

Adult↗