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

Table 1 Comparison of clinical and pathologic variables of study patients

Variables	CR group	PG group	P value
Age, median (range), in yr	58 (32-73)	61 (28-75)	0.532
Sex			0.168
Male	8	16
Female	10	9
Size in cm			0.549
≤ 2	1	0
2.1-5.0	6	6
5.1-10	7	13
> 10	4	6
Histologic type			0.71
Spindle	13	18
Epitheloid	1	3
Mixed	4	4
Mitotic index, per 50 HPF			0.766
≤ 5	13	17
> 5	5	8
Ki-67			0.163
≤ 5%	15	16
> 5%	3	9
CD117			0.929
Positive	16	22
Negative	2	3
CD34			0.159
Positive	15	24
Negative	3	1
DOG-1			0.083
Positive	13	23
Negative	5	2
NIH risk category			0.476
Very low risk	1	0
Low risk	5	4
Intermediate risk	7	12
High risk	5	9
Length of the upper edge of the GIST crossing the Z-line, mean ± SD (cm)	0.639 (0.29)	1.024 (0.395)	0.193
Circumference of the EGJ involvement			0.716
T ≤ 1/4	10	13
1/4 < T ≤ 2/4	7	8
2/4 < T ≤ 3/4	1	3
T > 3/4	0	1
Heartburn, postoperative
Yes	3	16	0.004
No	15	9
Oral antacids, postoperative
Yes	4	18	0.002
No	14	7

CR: Conformal resection; EGJ: Esophagogastric junction; GIST: Gastrointestinal stromal tumor; HPF: High-power field; PG: Proximal gastrectomy; T: Tumor.

Table 2 Comparison of intra-operative and postoperative variables between two surgical procedures for type A esophagogastric junction-gastrointestinal stromal tumors

	CR group, n = 18	PG group, n = 25	P value	95%CI
				Lower	Upper
Operating time in min	108.61 ± 30.13	137.80 ± 51.04	0.029	-56.41	-0.97
Intraoperative blood loss in mL	59.44 ± 23.08	90.60 ± 35.62	0.069	-53.53	-11.78
First passage of flatus time in h	29.11 ± 15.35	74.24 ± 40.39	0.013	-65.389	-24.87
Days to oral intake	3.56 ± 1.65	8.68 ± 3.88	0.006	-7.09	-3.16
Postoperative hospital stay in d	6.00 ± 2.40	10.96 ± 4.15	0.049	-7.17	-2.75
Negative margin, %	100	100

CI: Confidence interval; CR: Conformal resection; PG: Proximal gastrectomy.

Table 3 Postoperative esophageal 24-h pH parameters of patients who underwent surgery for type A esophagogastric junction-gastrointestinal stromal tumors

	Mean 24-h pH	Total time for pH < 4 (min)	Acid reflux number of 24 h		Regurgitation events, > 5 min
			Standing	Lying
CR group, n = 18	4.97 ± 1.44	31.83 ± 22.65	17.83 ± 11.25	35.62 ± 15.71	1.44 ± 1.68
PG group, n = 25	3.41 ± 1.15	184.48 ± 118.74	32.68 ± 15.89	58.81 ± 19.13	6.04 ± 1.92
P value	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

CR: Conformal resection; PG: Proximal gastrectomy.

Table 4 Postoperative health-related quality of life of study patients

	PF	RP	BP	GH	VT	SF	RE	MH
CR group, n = 18	53.72 ± 2.13	54.61 ± 1.61	60.94 ± 1.86	61.56 ± 1.75	61.72 ± 3.49	55.11 ± 2.24	50.61 ± 2.93	55.00 ± 2.27
PG group, n = 25	48.00 ± 3.64	48.36 ± 2.89	49.80 ± 4.12	50.72 ± 5.15	52.20 ± 4.06	44.60 ± 2.63	37.16 ± 4.08	46.12 ± 3.95
P value	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

BP: Bodily pain; GH: General health; MH: Mental health; PF: Physical function; RE: Role-emotional; SF: Social functioning; RP: Role physical; VT: Vitality.