ABSTRACT
There have been several reports of co-existing esophageal squamous cell carcinoma and esophageal submucosal tumor. However, there is no previous report describing a submucosal tumor located within an area of early esophageal cancer. This report presents the case of a 64-year-old man who developed early esophageal cancer with leiomyoma situated within the lesion in the upper third of the esophagus. Since leiomyoma existed within the area of the esophageal cancer, it was misdiagnosed as a component of esophageal cancer and the depth of esophageal cancer invasion was overdiagnosed by endoscopic ultrasonography. Therefore, surgery was chosen as treatment for esophageal cancer. If the leiomyoma had been diagnosed correctly as a submucosal tumor by endoscopy and endoscopic ultrasonography, an endoscopic mucosal resection would have been the therapeutic procedure of choice for an esophageal tumor.
Subject(s)
Carcinoma, Squamous Cell/surgery , Esophageal Neoplasms/surgery , Leiomyoma/surgery , Neoplasms, Multiple Primary/surgery , Carcinoma, Squamous Cell/diagnostic imaging , Endosonography , Esophageal Neoplasms/diagnostic imaging , Humans , Intestinal Mucosa/diagnostic imaging , Intestinal Mucosa/pathology , Leiomyoma/diagnostic imaging , Male , Middle Aged , Neoplasms, Multiple Primary/diagnostic imagingSubject(s)
Endoscopy, Digestive System/instrumentation , Esophagostomy/adverse effects , Mediastinal Diseases/surgery , Respiratory Tract Fistula/surgery , Tracheoesophageal Fistula/surgery , Anastomosis, Surgical , Constriction, Pathologic , Dilatation/adverse effects , Esophageal Neoplasms/surgery , Humans , Male , Middle AgedABSTRACT
Laparoscopy-assisted abdominal aortic aneurysm (AAA) repair consists of retroperitoneal laparoscopic dissection of the AAA and graft replacement performed via a mini-laparotomy. Two patients with infrarenal AAA underwent successful straight graft replacement using this hybrid approach. The retroperitoneal space was bluntly dissected under carbon dioxide pneumoretroperitoneum and further dissection was performed laparoscopically. This enabled proximal and distal control of the aneurysm, and occlusion of the lumbar arteries and the inferior mesenteric artery with hemoclips. A 7 cm mini-laparotomy was sufficient for the straight graft replacement. Laparoscopy-assisted repair is a less invasive technique for the treatment of AAA and can be regarded as the initial step towards totally endoscopic repair.
