Matched cohort compares endoscopic and thoracoscopic resection of esophageal leiomyoma

A retrospective cohort study of 1,348 patients compared endoscopic resection with minimally invasive thoracic surgery for esophageal leiomyoma. After propensity score matching, endoscopic resection was associated with shorter operations and hospital stays, while thoracic surgery was used more often for larger tumors.

Matched analysis included 113 patient pairs.
Endoscopic resection was associated with shorter operations and stays.
Thoracic surgery was used for larger tumors.
Retrospective findings do not establish universal treatment superiority.

Researchers retrospectively reviewed patients who underwent resection of pathologically confirmed esophageal leiomyoma between January 2015 and September 2023. The primary analysis included 1,348 patients: 1,216 treated endoscopically and 132 with minimally invasive thoracic surgery. The investigators used 1:1 propensity score matching on age, sex, tumor location and maximal diameter; 113 matched pairs were analyzed.

In the full cohort, endoscopic resection was associated with shorter operative time (mean 41.9 vs 114.8 minutes) and shorter postoperative stay (median 2 vs 5 days). Thoracic surgery was used for larger tumors (median diameter 5.0 vs 1.3 cm). In the matched cohort, endoscopic resection remained associated with shorter operative time (73.7 vs 111.6 minutes) and hospital stay (median 3 vs 5 days); nasogastric tube placement and stays of at least five days were also less common.

The findings suggest differences in recovery and treatment selection, not proof that one approach is superior for all patients. The retrospective design and marked tumor-size differences limit comparisons, even after matching. The authors conclude that size and location should inform approach selection; the study does not establish a universal preference.

In practice

For patients undergoing resection of esophageal leiomyoma, the study found shorter operative times and postoperative stays associated with endoscopic resection, while thoracic surgery was used more often for larger tumors. These findings may inform discussion of procedural options in relation to tumor characteristics, but do not establish which approach is preferable for an individual patient. The evidence is retrospective, and matching cannot eliminate unmeasured differences or fully resolve selection bias; the data do not support a universal preference for either technique.

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Source

Surgical Endoscopy: Thoracoscopic versus endoscopic resection for esophageal leiomyoma: a propensity score-matched retrospective cohort study ↗

This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.