Surgical resection of esophagogastric junction stromal tumor: How to protect the cardiac function

Figure 1 Schematic diagram of esophagogastric junction-gastrointestinal stromal tumor. Z-line: Squamocolumnar junction; Type A: Defined as esophagogastric junction-gastrointestinal stromal tumor involving Z-line; Type B: Defined as esophagogastric junction-gastrointestinal stromal tumor near Z-line.

Figure 2 Conformal resection of type A esophagogastric junction-gastrointestinal stromal tumor located in the anterior wall of esophagogastric junction. A: The abdominal computed tomography showing the lesion located in the anterior wall of the esophagogastric junction; B: Exploratory laparotomy; C: Removal of the tumor with preservation of esophagogastric junction and esophageal wall as much as possible; D: Suturing of the esophageal wall to the gastric wall to prevent stenosis; E: The final appearance after suturing.

Figure 3 Conformal resection of type A esophagogastric junction-gastrointestinal stromal tumor located in the posterior wall of esophagogastric junction. A: The abdominal computed tomography showing the lesion located in posterior wall of the esophagogastric junction; B: Anterior gastrotomy to visualize the lesion; C: Removal of the tumor; D: Suturing of the posterior wall of the esophagus to the gastric wall.

Figure 4 Gastroduodenal endoscopy 2 mo after the operation. A: Gastric view; B: Esophageal view.

Figure 5 The receiver operating characteristic curve analyses showed that the best cut-off value of distance of involving Z-line was 7. 0 mm.

Figure 6 The disease-free survival between conformal resection group and proximal gastrectomy group (P = 0. 163). CR: Conformal resection; PG: Proximal gastrectomy.