Minimally invasive treatment of benign esophageal tumors

Benign esophageal tumors are rare entities that constitute less than 0.5 % of the population on autopsy (Plachta A, Am J Gastroenterol 38:639-652, 1962; Attah EB, Hajdu SI, J Thorac Cardiovasc Surg 55(3):396-404, 1968) and only 1-2 % of resected esophageal neoplasms (Nguyen NT, Reavis KM, El-Badawi K, Hinojosa MW, Smith BR, Surg Innov 15(2):120-125, 2008). Most of them are clinically unremarkable. Thus, expectant management of a small, benign-appearing solid or cystic lesion may be acceptable. Traditionally, the management of larger or symptomatic lesions is surgical resection. With advances in minimally invasive surgical and endoscopic techniques in last decades, tumor removal can be achieved by a variety of methods. Generally, small intraluminal lesions can be managed with simple endoscopic ablation or resection. Endoscopic mucosal resection may be used for the removal of submucosal lesions, but only by an experienced endoscopist. For large intramural or extramural lesions, enucleation or even resection by using thoracoscopic or laparoscopic techniques has demonstrated feasibility and efficacy as a treatment of choice alongside standard thoracotomy or laparotomy.