Simultaneous removal of two esophageal leiomyomas by tunnel endoscopic resection

Gorbachev E.V.; Fedorov E.D.; Shapovolyants S.G.; Plakhov R.V.; Budzinsky S.A.

doi:https://doi.org/10.17116/endoskop20212702133

Gorbachev E.V.

Pirogov Russian National Medical University;
City Clinical Hospital No. 31

Fedorov E.D.

Pirogov Russian National Research Medical University of the Russian Ministry of Health

SPIN RSCI: 6785-9959
Scopus AuthorID: 7004381289
ORCID: 0000-0002-6036-7061

Shapovolyants S.G.

Pirogov Russian National Research Medical University

Plakhov R.V.

Pirogov Russian National Research Medical University;
City Clinical Hospital No. 31

Budzinsky S.A.

Pirogov Russian National Research Medical University;
City Clinical Hospital No. 31

Simultaneous removal of two esophageal leiomyomas by tunnel endoscopic resection

Authors:

Gorbachev E.V., Fedorov E.D., Shapovolyants S.G., Plakhov R.V., Budzinsky S.A.

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Journal: Endoscopic Surgery. 2021;27(2): 33‑39

DOI: 10.17116/endoskop20212702133

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To cite this article:

Gorbachev EV, Fedorov ED, Shapovolyants SG, Plakhov RV, Budzinsky SA. Simultaneous removal of two esophageal leiomyomas by tunnel endoscopic resection. Endoscopic Surgery. 2021;27(2):33‑39. (In Russ.)
https://doi.org/10.17116/endoskop20212702133

Подписка 2026 Эндоскопическая хирургия (Endoscopic Surgery)

Использование инфографики авторами научных работ

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Abstract:

OBJECTIVE

Demonstration of the endoscopic tunnel resection’s opportunities with simultaneous removal of two leiomyomas located on different walls of the esophagus through a single submucosal tunnel

MATERIAL AND METHODS

A clinical case of a 65-year-old patient B. is presented. She was admitted to the clinic with complaints of a sensation of an obstacle in the passage of food through the esophagus and carcinophobia. With EGD and probe EUS it was revealed that in the mid-thoracic region of the esophagus there are two sub-epithelial lesions (SELs) located along the posterior-right and posterior-left walls; it slightly prolapsing into the lumen of the esophagus having a uniform hypoechoic echo structure and clear even contours without echo-graphic signs of malignancy originating from the own muscular layer of the esophagus with a predominantly intramural growth pattern; most likely leiomyomas.

RESULTS

According to clinical indications SELs were removed by the SET which was performed under general anesthesia. Taking into account the eccentric arrangement of the lesions it was decided to perform an initiation incision of the mucosa so that the center of the tunnel passes between the two lesions. After the creation of the tunnel it was not possible to detect the formations visually which was due to their intramural location. Only after dissection of the circular muscle fibers in the projection of the largest formation it began partially to prolapse into the lumen of the esophagus. Alternately, SELs were removed as a single block. The tunnel is closed with endo-clips. There were no intra- and postoperative complications. The histological conclusion was two leiomyomas of the mid-thoracic esophagus.

CONCLUSION

An individual approach to treatment tactics and the possibility of removing two SELs of the esophagus located on different walls using one tunnel approach, thereby reducing the risks of intra- and postoperative complications have been demonstrated.

Keywords:

leiomyoma

endoscopic tunnel resection

submucosal tumor

STER

Authors:

Gorbachev E.V.

Pirogov Russian National Medical University;
City Clinical Hospital No. 31

Fedorov E.D.

Pirogov Russian National Research Medical University of the Russian Ministry of Health

SPIN RSCI: 6785-9959
Scopus AuthorID: 7004381289
ORCID: 0000-0002-6036-7061

Shapovolyants S.G.

Pirogov Russian National Research Medical University

Plakhov R.V.

Pirogov Russian National Research Medical University;
City Clinical Hospital No. 31

Budzinsky S.A.

Pirogov Russian National Research Medical University;
City Clinical Hospital No. 31

Received:

10.08.2020

Accepted:

18.11.2020

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