What complication should be avoided via biopsy in patients with esophageal leiomyoma?

In patients with esophageal leiomyoma, the primary complication that should be avoided through the biopsy procedure is scarring that complicates later resection. When performing a biopsy on a leiomyoma, it is crucial to minimize trauma to the tissue, as the esophagus is a delicate structure, and any unnecessary manipulation can lead to scarring. This scarring can make subsequent surgical procedures more difficult, potentially complicating the resection of the tumor if it is determined that surgical intervention is necessary.

This is particularly important for leiomyomas, as they can be treated with surgical excision when they cause symptoms or if they are particularly large. If significant scarring occurs from an earlier biopsy, it could hinder the surgeon's ability to adequately access and remove the tumor, potentially leading to complications during the surgical procedure.

Additionally, while perforation, bleeding, and infection are potential risks associated with any biopsy, they are not as specific to leiomyomas or as serious in terms of impacting subsequent surgical options as scarring is. By focusing on avoiding scarring, clinicians can help ensure a more straightforward approach if surgical management becomes warranted later.