Leiomioma do esôfago removido por videolaparoscopia

Leiomyoma of the lower esophagus treated by videolaparoscopy

Laparoscopy; Esophagus; Surgery; Surgical techniques; Leiomyoma; BeniRn neoplasms

RELATOS DE CASOS

Leiomioma do esôfago removido por videolaparoscopia

Leiomyoma of the lower esophagus treated by videolaparoscopy

João Luiz M. C. Azevedo, TCBC-SP^I; Jean Boulez^II; Marie Cecile Blanchet^II

^IProfessor Adjunto Doutor do Departamento de Cirurgia da UNIFESP - EPM, PhD, FICS

^IIProfessor Titular do Departamento de Cirurgia General e Digestiva da Faculdade de Medicina da Universidade Claude Bernard, Lyon, França

^{Endereço para correspondência}

ABSTRACT

This report describes a leiomyoma of the inferior third section of the esophagus removed during laparoscopic cholecystectomy. The patient is a woman 55-years-age, carrying esophageal myoma of 40 mm in diameter wide, situated in the posterior wall of the lower esophagus. Indications for surgery were based mainly on the growth of the mass (6 mm when discovered 7 years previously, increased to 40 mm). Recently the patient returned suffering from pain, which could be attributed to his litiasic cholecystopaty. A small degree of low disphagia could also be observed. Radiologic imaging, direct endoscopic examination and endoscopic ultrasound showed that the mioma protruded on to the oesophagic lumen, discreetly diminishing there. A laparoscopic esophageal myomectomy was indicated at the same session of the laparoscopic cholecystectomy. Once the pneunoperitoneum was installed, five ports were placed as if for a hiatus hernia surgery. The cholecystectomy was uneventful. Next, an esophagoscopy was performed so as to determine the precise area covering the base of the tumour; at the right-lateral site. Longitudinal and circular fibres of the esophagus was severed over the lesion and the enucleation of the tumour was performed alternating the monopolar dissection, bipolar and hidrodisection. Control-endoscopy was carried out to verify mucosa integrity. Four suture points with poliglactine 3-0 string so as to close the musculature followed this. One suture was placed in for diminution of the size of the esophagean hiatus. Total time of intervention: two hours (30m for the cholecystectomy and one hour and thirty minutes for the myomectomy). Postoperative period: uneventful. Disappearance of the disphagia was observed. Radiologic transit control with water-soluble contrast at 4th post-operative day: good passage. Diagnosis from laboratory of pathology: conjunctive tumour formed by muscle non-striated cells: leiomyoma. The patient was re-examined on the two-month postoperative follow-up. General conditions were good and there were no complain of dysphagia. Neither there were any symptoms of gastro-esophageal reflux.

Key words: Laparoscopy; Esophagus; Surgery; Surgical techniques; Leiomyoma; BeniRn neoplasms.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Recebido em 25/1/99

Aceito para publicação em 15/7/99

Trabalho realizado na Fédération des spécialités digestives, Pavillon D-O, Hôpital E. Herriot.

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Datas de Publicação

• Publicação nesta coleção
  26 Jan 2010
• Data do Fascículo
  Ago 1999

Histórico

• Recebido
  25 Jan 1999
• Aceito
  15 Jul 1999