食道平滑肌瘤虽然罕见，但是是该器官中最常见的良性肿瘤。手术方法已经从开放性胸腔切开或腹腔切开演变为视频辅助胸腔镜或腹腔镜手术，现在是机器人摘除术。我们报道了一组19例中下段食道平滑肌瘤的微创手术治疗病例。对印度一家三级医疗中心进行了19例手术的回顾性分析。在计算机断层扫描（CT）和内窥镜超声（endosonography）确诊是良性食道肿瘤后，分别进行了下段肿瘤的腹腔镜经食管切台部摘除术（n = 16）和中段肿瘤的右侧视频辅助胸腔镜切除术（n = 3）。在下段食道平滑肌瘤切除术后进行了Dor fundoplication。发现患者主要症状为胸骨后灼热感，中段食道肿瘤则无症状，并作为偶然发现。肿瘤的大小范围为3厘米至8厘米，根据增强CT扫描决定尺寸。平均手术时间为93分钟，范围为61至137分钟。平均失血量为53毫升。无患者出现系统性食管粘膜损伤。无转为开放手术或发生主要并发症，包括术后漏出或死亡。术后恢复顺利。对于下段食道平滑肌瘤的食管切台术是策略性的，可以避免胸腔镜的并发症，微创且费用较低，适用于充分暴露，并且在有经验的腹腔镜外科医生手中也是安全的。

Leiomyoma of the oesophagus, although rare, is the most common benign tumour to occur in the organ. Surgical approaches have evolved over time from an open thoracotomy or laparotomy to video-assisted thoracoscopic or laparoscopic and now robotic enucleation. We report a series of 19 cases of leiomyoma of the middle- and lower-third oesophagus treated by minimally invasive surgery.A retrospective analysis of 19 cases operated at a single tertiary care centre in India was performed. After the diagnosis of a benign oesophageal neoplasm on computed tomography (CT) and endosonography, laparoscopic transhiatal enucleation of the tumour for lower third (n = 16) and right-sided video-assisted thoracoscopic excision for middle-third tumours (n = 3) were performed. Dor fundoplication was done after the excision of leiomyomas from the lower oesophagus.The most common symptom at presentation was retrosternal burning in lower oesophageal tumours, while tumours in the middle third of the oesophagus were asymptomatic and incidentally detected. The size of the tumour ranged from 3 cm to 8 cm in the largest dimension on contrast-enhanced CT scan. The mean operative time was 93 min ranging from 61 to 137 min. The average blood loss was 53 ml. No patient had an iatrogenic oesophageal mucosal injury. There were no conversions to open surgery or major complications including post-operative leak or death. Post-operative recovery was uneventful.The transhiatal approach to lower oesophageal leiomyomas is strategic to avoid complications of thoracoscopy, minimally invasive, cost-effective as compared to robotic surgery, suitable for adequate exposure and safe in the hands of an experienced laparoscopic surgeon.