LEIOMYOMAS OF THE LOWER 3RD OF THE ESOPHA GUS - VALUE OF TRANSHIATAL ENUCLEATION

Leiomyomas are the common est benign tumors of the esophagus and most of them are located in the lower third. Dysphagia and vague pain are t he most frequent symptoms. However, 50 % of the patients remain asympt omatic and the tumor is often discovered incidentally. Operative manag ement by transthoracic enucleation is the procedure of choice but for asymptomatic forms, this remains controversial. In addition, gastro-es ophageal reflux frequently coexists with an esophageal leiomyoma and t he therapeutic indications are not well defined for such situations. W e report 3 cases of esophageal leiomyoma situated in the lower third, with emphasis on the operative management by transhiatal enucleation, particularly in case of coexisting gastro-esophageal reflux. This proc edure avoids thoracotomy and the surgical treatment of the associated gastro-esophageal reflux is much easier by this approach than with tho racotomy.