Document Detail

Laparoscopic surgery for an unusual case of dysphagia: lower oesophageal leiomyoma co-existing with achalasia cardia.
MedLine Citation:
PMID:  18204755     Owner:  NLM     Status:  MEDLINE    
Benign tumours of the oesophagus are rare, with an incidence of ten percent. Leiomyomas are the most common benign tumours and are located frequently in the middle and lower third of the oesophagus. Coexisting achalasia cardia is very rare. We present a 63-year-old man with coexisting leiomyoma and achalasia presenting with dysphagia for 25 days. Endoscopy and manometry revealed achalasia cardia at the lower third. Barium swallow showed a tumour proximal to the narrowing. Laparoscopic transhiatal enucleation and cardiomyotomy with Toupet fundoplication was successfully performed. Several conditions have been described to coexist with achalasia cardia, such as cancer, paraoesophageal hernia and hiatal hernia. Based on our experience, we feel that lower oesophageal tumours are best approached by a laparoscopic transhiatal route and the presence of achalasia in this case did not change the approach as cardiomyotomy with fundoplication could also be simultaneously performed. Minimally-invasive surgery for benign oesophageal tumours reduces the morbidity of thoracotomy or laparotomy.
C Palanivelu; M Rangarajan; R Senthilkumar; M V Madankumar
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Singapore medical journal     Volume:  49     ISSN:  0037-5675     ISO Abbreviation:  Singapore Med J     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-21     Completed Date:  2008-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404516     Medline TA:  Singapore Med J     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  e22-5     Citation Subset:  IM    
Department of Surgical Gastroenterology, Gastroenterology Medical Centre and Hospital, 45-A Pankaja Mill Road, Ramnathapuram, Coimbatore 641045, India.
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MeSH Terms
Barium / diagnostic use
Deglutition Disorders / complications,  surgery*
Esophageal Achalasia / complications,  surgery*
Esophageal Neoplasms / complications,  surgery*
Esophagus / pathology
Laparoscopy / methods*
Leiomyoma / complications,  surgery*
Manometry / methods
Middle Aged
Reg. No./Substance:

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