[Leiomyomas of the lower third of the esophagus. 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 the most frequent symptoms. However, 50% of the patients remain asymptomatic and the tumor is often discovered incidentally. Operative management by transthoracic enucleation is the procedure of choice but for asymptomatic forms, this remains controversial. In addition, gastro-esophageal reflux frequently coexists with an esophageal leiomyoma and the therapeutic indications are not well defined for such situations. We 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 procedure avoids thoracotomy and the surgical treatment of the associated gastro-esophageal reflux is much easier by this approach than with thoracotomy.