What is the surgical approach for esophageal leiomyoma if surgery is necessary?

The surgical approach for esophageal leiomyoma typically involves a thoracotomy for excision, particularly when the tumor is located in the intrathoracic portion of the esophagus. This approach allows adequate exposure of the esophagus and the surrounding structures, which is crucial for safely and effectively removing the leiomyoma.

Performing a thoracotomy enables the surgeon to directly visualize the tumor, which is important for achieving complete resection while minimizing the risk of injury to adjacent tissues, such as the aorta or surrounding lung structures. The thoracic approach also allows for easier reconstruction of the esophageal wall after the tumor is removed, thereby reducing the likelihood of complications like stricture or leakage.

Other surgical options, such as a transabdominal laparoscopic approach or an open abdominal technique, may not provide the same level of access and visibility for tumors located in the thoracic esophagus. Endoscopic resection is an option for smaller lesions or superficial tumors but may not be suitable for larger leiomyomas, as it may not achieve complete removal and carry a higher risk of recurrence.

Ultimately, the choice of surgical technique is influenced by the size and location of the leiomyoma, but a thoracotomy remains the standard approach when surgical intervention