For esophageal leiomyoma, surgical enucleation is accepted as the standard procedure when the tumor is symptomatic or large in size without malignant findings. The aim of this study is to clarify the long-term results following thoracoscopic surgery. Four patients with esophageal leiomyoma were subjected to thoracoscopic surgery. The indications for surgical resection of esophageal leiomyoma were as follows: 1) tumor size greater than 3cm or appearance of enlargement; 2) symptomatic patients. In one case of a larger tumor, hand-assisted thoracoscopic surgery was performed in order to ensure both minimal invasion and a wide operative area. There was no mortality and one postoperative complication. No local recurrence, port site recurrence, pleural dissemination or distant metastases were detected between 35 and 96 months after the operation. The advantages of thoracoscopic surgery for esophageal leiomyoma include its safety and long-term prevention of recurrence.
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