Successful resection of large submucosal tumor in the esophagus: Novel thoracoscopic-endoscopic combined surgery with submucosal tunneling method

Patients with esophageal leiomyoma, a benign submucosal tumor originating from the muscularis propria of the esophagus, present with dysphagia or chest pain depending on the tumor size and site. Conventional thoracoscopic surgery may cause a large muscle defect, possibly leading to esophageal stricture. As regards endoscopic procedures, there is a limit to the size of tumor that can be resected [1]. We report five cases of successful resection of large symptomatic leiomyomas with the thoracoscopic-endoscopic submucosal tunneling method (TEST), a novel treatment first reported in 2016 [2]. Results with the first of five cases demonstrate that the method has advantages for both thoracoscopic and endoscopic resection.