J Gastroenterol Hepatol Endosc | Volume 2, Issue 6 | Case Report | Open Access

Combined Approach to a Giant Esophageal Polyp: Case Report and Literature Review

Krasimir Ivanov¹, Valentin Ignatov¹, Dilyan Petrov¹, Anton Tonev^1*, Aleksandar Zlatarov¹, Boryana Naydenova², Nikolay Sapundzhiev³ and Nikola Kolev

¹Department of General and Operative Surgery, Medical University “Prof. Paraskev Stoyanov” of Varna, Varna, Bulgaria
²Department of Anesthesiology, Emergency and Intensive Medicine, Medical University “Prof. Paraskev Stoyanov” of Varna, Varna, Bulgaria
³Department of Neurosurgery and ENT Diseases, Division of ENT Diseases, Medical University “Prof. Paraskev Stoyanov” of Varna, Varna, Bulgaria

^*Correspondance to: Anton Tonev 

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Abstract

Benign esophageal tumors are less common than esophageal malignancies. Benign lesions may reach gigantic size and then provoke dysphagia, chest pain, food regurgitation, and weight loss typical of other more common diseases of the esophagus. There are scanty reports in the literature available describing different approaches in the surgical treatment of giant esophageal polyps. We present a case of a 65-year-old male patient with a 14.5 cm × 5.5 cm × 4 cm fibrovascular esophageal polyp originating from the hypopharynx. The diagnostic modalities include endoscopy, computer tomography, magnetic-resonance imaging, and virtual angiography. Under general anesthesia with transnasal endotracheal reinforced tube, an endoscopic approach by using of a Weerda distending diverticuloscope is achieved. Manipulations are performed with a flexible gastroscope and 10 mm 30° angled laparoscope. The flexible endoscope passes easily around the mass and reaches the stomach without any signs of esophageal wall injury. After catching the polyp’s pedicle with a suture loop, it is sclerotized and resected with 5-mm laparoscopic Ligasure. There are no pertinent publications on this approach in the literature available yet. Because of the considerable polyp size, a transgastric extraction is carried out. The postoperative course is uneventful. There is no recurrence after two-year follow-up.

Keywords:

Gastrointestinal endoscopic surgery; Giant esophageal fibrovascular polyp; Weerda diverticuloscope; Ligasure; Bipolar tissue sealing device

Citation:

Ivanov K, Ignatov V, Petrov D, Tonev A, Zlatarov A, Naydenova B, et al. Combined Approach to a Giant Esophageal Polyp: Case Report and Literature Review. J Gastroenterol Hepatol Endosc. 2017;2(6):1032.