Thoracoscopic Enucleation of an Esophageal Gastrointestinal Stromal Tumor

Introduction: Symptomatic gastrointestinal stromal tumors of the esophagus present a technical challenge with regards to their safe removal. Located within the muscularis propria, these tumors are not typically amenable to endoscopic resection. We describe the technique of thoracoscopic enucleation in a patient with a 3 cm esophageal gastrointestinal stromal tumor located in the middle esophagus.

Methods: Thoracoscopy was accomplished with the patient in left lateral decubitus position using dual lumen intubation with right lung desufflation and the placement of four trocars. The mediastinal pleura overlying the esophagus was incised. The esophagus was mobilized and retracted until the tumor was adequately exposed. A longitudinal esophageal myotomy was performed and the tumor was enucleated. The myotomy was closed with a running permanent suture. The specimen was removed through the 12mm port site.

Results: The operative time was 2 hours 15 minutes. Estimated blood loss was 75 mL. On postoperative day 1, an esophagram was negative for leak or obstruction and the patient was started on a clear liquid diet. The patient was discharged on postoperative day 3 and advanced to a regular diet on postoperative day 7.

Conclusion: Thoracoscopic enucleation of esophageal gastrointestinal stromal tumors can be performed safely with minimal morbidity.

Session: Podium Video Presentation

Program Number: V050

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