• Journal of Chest Surgery
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• v.26 no.8
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• pp.627-632
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• 1993

A clinical study was performed on 64 cases of the esophageal diseases experienced at the Department of Thoracic & Cardiovascular Surgery of Kyungpook University Hospital from Jan. 1988 through Dec. 1992. The results were as follows: The most common esophageal disease was cancer which occurred in 37.5% of the total. In esophageal cancer patients, 24 cases were operated on and cancer resection was feasible in 19 cases with 2 cases of hospital death. The overall 1 year survival rate was 41.6% and the most favorable follow up result was revealed in stage I group. Esophageal stricture occurred in 22 cases and its causes were alkali and acid. The most common stricture site was mid-esphagus. Colon interposition was performed on 15 cases. Achalasia occured in 8 cases and was treated with modified Heller`s myotomy. Esophageal perforation occurred in 6 cases and its operative mortality rate was 16.6%. Two patients with congenital bronchoesophageal fistula were treated with surgical division. The first case, which occurred in an adult, is of Braimbridge,s typeII classification. The second one which occured in an child with sequestration, is of Braimbridge,s type IV classification. Diverticulectomy was performed in 1 case of esophageal diverticulum. Enucleation of tumor was performed in 1 case of esophageal leiomyoma.

• Korean Journal of Bronchoesophagology
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• v.15 no.1
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• pp.24-27
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• 2009

Background: Benign tumors of the esophagus are rare. They include leiomyomas, gastrointestinal stromal tumors, neurofibromas and lipomas. In this study we present our experience with enucleation of these 13 tumors for 10 years. Material and Method: A retrospective review of patients who underwent enucleation of benign esophageal tumors between 1995 and 2005 was conducted. Symptom, tumor location and size, operative approach and outcomes after surgery were recorded. Result Thirteen patients were identified(leiomyoma: n=12; GIST n=l). Eight patients were men, five patients were women. Most of them were 4rd and 5th decade. The tumors arose in the lower(7 patients) and middle(6 patients) thirds of the esophagus. Eleven patients underwent a thoracotomy; the remainder were resected using VATS. All of patients underwent simple enucleation. There were no complications and recurrences after surgery. Conclusion: We present our experience with enucleation of these 12 leiomyomas and one GIST for 10 years.

• Korean Journal of Bronchoesophagology
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• v.9 no.1
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• pp.87-91
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• 2003

Currently gastrointestinal mesenchymal tumors are divided into three major categories: myogenic tumors(leiomyoma, leiomyosarcoma), neurogenic tumors (schwannomas) and neoplasms that belong to neither group, which are known by GIST(gastrointestinal stromal tumors). The stromal tumors are hetrogenous, so that they may show myogenic or neurogenic differentiation or both, or no differentiation at all in some patients. The best defining feature for GIST is their expression of KIT-protein(CD117). Leiomyomas are the most common mesenchymal tumor in esophagus. Esophageal GISTS are very rare in comparision to those of the stomach and intestine. Recently we experieneced one case of the esophageal GIST, so that we describe an esophageal GIST on immunohistochemical analysis. A 70 years old woman complained of dysphagia and nausea for 3 days. FGS showed a huge elevated lesion in lower esophagus 33cm distal to incisor, which was covered with normal mucosa. CT and UGI showed the intramural tumor of lower third of the esophagus. The distal esophagectomy and esophago-gastrostomy were performed. The tumor was located in lower third of esophagus and measured as $6{\times}3.7$cm in size. Immunohistochemically, it showed weakly positive CD117 and diffusely positive S-100. SMA, desmin, NES and chromogranin showed negative immune-reaction. The patient was followed for 15 month after operation. There was no recurrence.

• Journal of Chest Surgery
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• v.22 no.3
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• pp.518-523
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• 1989

A 42-year old male was seen with symptoms of dysphagia, chest pain and dyspnea of 9 months duration. A benign tumor of the posterior mediastinum was diagnosed from x-ray studies and a transthoracic needle aspiration biopsy which was inconclusive. A left thoracotomy revealed a huge mass occupying the retrocardiac space and the contra-lateral mediastinum. It was resected by blunt dissection and, during this process, a 3.0 cm laceration was created in the esophageal wall. This was repaired with Tevdec sutures and staplers and was reinforced with an intercostal muscle flap to prevent leakage. The postoperative course was entirely uneventful.

• Journal of Chest Surgery
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• v.39 no.11 s.268
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• pp.875-878
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• 2006

A 39-year-old man presented with a esophageal submucosal tumor on regular check up examination. Preoperative exams showed the typical submucosal tumor as leiomyoma and operative procedure was enucleation for complete resection. Postoperative pathologic diagnosis including histologic and immunohistochemical study was compatible with plexiform schwannoma. Plexiform schwannoma is one of the least common variant of schwannoma that typically shows a plexiform or multinodular pattern. To our knowledge, there is rare case report of plexiform schwannoma originating in the esophagus and we report ore case with related literature.

• Journal of Chest Surgery
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• v.39 no.7 s.264
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• pp.565-568
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• 2006

A 46-year-old man who had been diagnosed with esophageal tumor by PET-CT was admitted to our hospital for operation. Preoperative examination and intraoperative findings showed leiomyoma-like lesion and enucleation was done, but an immunohistochemical test on the case found gastrointestinal stromal tumor (GISTs). GISTs are very rarely found in the esophagus. As GISTs differ from leiomyoma pathogenetically and clinically, different treatments and follow-up strategies are required. The patient is under continuous observation to check recurrence and metastasis.

• Journal of Chest Surgery
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• v.33 no.9
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• pp.738-743
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• 2000

Background: Video-assisted thoracic surgery(VATS) is being used as a therapeutic modality in many diseases in which thoracotomy has been used. We studied that the VATS can substitute the thoracotomy in benign esophageal disease. Material and Method: Group I (n=18) underwent video-assisted thoracic surgery, and group II(n=19) thoracotomy. Group I includes 14 leiomyomas and 4 achalasias. Group II includes 16 leiomyomas and 3 achalasias. Operative technique is enucleation in the leiomyoma and modified Heller's myotomy in the achalasia. Analyzing factors of operation-efficacy are anesthetic time, operation time, hospital stay, chest tube drainage amount and chest tube removal day. The degree of the postoperative pain is assessed by the frequency of opioid analgesics injection. Result: There was no death in both groups. There were 5 complications in the group I and 2 in the group II. Prolonged pleural effusion and restenosis of achalasia occurred to 1 patient in each group. In the group I, there were 1 temporaty vocal cord palsy and 2 mucosal tear leading to thoracotomy. There were no differences in anesthesia time, operation time, hospital stay, total chest tube drainage amount, chest tube removal day and frequency of opioid analgesics injection. The amount of the chest tube drainage at POD 1 day was significantly lower in group I(155.6$\pm$77.8cc) than in group II(572.8$\pm$280.1cc)(p<0.05). Conclusion: The results of our data showed that video-assisted thoracic surgery for benign esophageal disease is as effective as thoracotomy and in addition, cosmetic effect is much better. We concluded VATS may be a substitute for thoracotomy in benign esophageal disease.

• Korean Journal of Radiology
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• v.2 no.3
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• pp.132-137
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• 2001

Objective: The aim of our study was to describe and compare the radiologic findings of esophageal leiomyomas. Materials and Methods: The chest radiographic (n = 12), esophagographic (n = 12), CT (n = 12), and MR (n = 1) findings of surgically proven esophageal leiomyomas in 12 consecutive patients [ten men and two women aged 34 - 47 (mean, 39) years] were retrospectively reviewed. Results: The tumors, surgical specimens of which ranged from 9 to 90 mm in diameter, were located in the upper (n = 1), middle (n = 5), or lower esophagus (n = 6). In ten of the 12 patients, chest radiography revealed the tumors as mediastinal masses. Esophagography showed them as eccentric, smoothly elevated filling defects in 11 patients and a multilobulated encircling filling defect in one. In 11 of the 12 patients, enhanced CT scans revealed a smooth (n = 9) or lobulated (n = 2) tumor margin, and attenuation was homogeneously low (n = 7) or iso (n = 4). In one patient, the tumor signal seen on T2-weighted MR images was slightly high. Conclusion: Esophageal leiomyomas, located mainly in the middle or distal esophagus, are consistently shown by esophagography to be mainly eccentrically elevated filling defects and at CT, lesions showing homogeneous low or isoattenuation are demonstrated.

• Journal of Chest Surgery
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• v.48 no.1
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• pp.40-45
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• 2015

Background: Surgical enucleation is the treatment of choice for esophageal submucosal tumors (SMTs) with symptomatic, larger, or ill-defined lesions. The enucleation of SMTs has traditionally been performed via thoracotomy. However, minimally invasive approaches have recently been introduced and successfully applied. In this study, we present our experiences with the thoracotomic and thoracoscopic approaches to treating SMTs. Methods: We retrospectively reviewed 53 patients with SMTs who underwent surgical enucleation between August 1996 and July 2013. Demographic and clinical features, tumor-related factors, the surgical approach, and outcomes were analyzed. Results: There were 36 males (67.9%) and 17 females (32.1%); the mean age was $49.2{\pm}11.8$ years (range, 16 to 79 years). Histology revealed leiomyoma in 51 patients, a gastrointestinal stromal tumor in one patient, and schwannoma in one patient. Eighteen patients (34.0%) were symptomatic. Fourteen patients underwent a planned thoracotomic enucleation. Of the 39 patients for whom a thoracoscopic approach was planned, six patients required conversion to thoracotomy because of overly small tumors or poor visualization in five patients and accidental mucosal injury in one patient. No mortality or major postoperative complications occurred. Compared to thoracotomy, the thoracoscopic approach had a slightly shorter operation time, but this difference was not statistically significant ($120.0{\pm}45.6$ minutes vs. $161.5{\pm}71.1$ minutes, p=0.08). A significant difference was found in the length of the hospital stay ($9.0{\pm}3.2$ days vs. $16.5{\pm}5.4$ days, p<0.001). Conclusion: The thoracoscopic enucleation of submucosal esophageal tumors is safe and is associated with a shorter length of hospital stay compared to thoracotomic approaches.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1123-1128
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• 1996

A clinical study was performed on 152 cases of surgical esophageal disease treated by the Department of Thoracic & Cardiovascular Surgery of Korea University Hospital from Jan. 1989 through July 1994. The most common esophageal disease was cancer which was seen in 73 cases (48%) among 152 cases. All were treated surgically' 52 patients (71%) were managed by curative or palliative resection with reconstruction and feeding gastrostomy or jejunostomy, otherwise Celestine tube insertion was performed on the remaining 21 patients for palliatio'n. Esophageal leiomyoma occurred in 6 cases(3.9%), among them 1 case was performed with trio recoscopic enucleation . Achalasia were in 7 cases (4.6%) and was treated with modified Heller's m otomy and with Belsey Mark IV operation. Diverticulum were in 11 cases (7.2%). Esophageal stricture occurred in 20 cases (14.1 %) and 17 of 20 cases were managed with bypass surgery. Esophageal perforation was seen in 20 cases, its cause was instrumental trauma in 7 cases, stab wound in 4 cases, foreign body in 4 cases, spontaneous perforation in 3 cases, and others 1 case Other disease including congenital lesion was seen In 1 Scases.