Abstract
Herein, we report a case of a gastrointestinal stromal tumor (GIST) at the esophagogastric junction (EGJ) that was successfully treated by a laparoscopic wedge resection (LWR) after dissection of the seromuscular layer around the tumor to prevent postoperative deformities and stenosis of the EGJ. Subsequently, the abdominal esophagus was wrapped by the gastric fornix according to Dor’s method in order to prevent reflux esophagitis after surgery.A 71-year-old female patient was admitted with a diagnosis of a GIST (23 × 20 × 20 mm) at the EGJ. We performed the abovementioned operation.Gastroduodenal endoscopic examination revealed no deformity or stenosis of the EGJ at 6 months after the operation. The patient has not experienced any reflux symptoms. Tumor recurrence was not noted 26 months after the operation.This procedure is useful in preventing the deformity and stenosis of the EGJ as well as postoperative reflux esophagitis.
Highlights
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract
As much of the normal gastric wall around the tumor may be removed in laparoscopic wedge resection (LWR) for GIST, severe deformity and stenosis of the stomach and disturbance of gastric function often occur after LWR, especially for GIST at the esophagogastric junction (EGJ)
We report a case of a gastric GIST at the EGJ that was successfully treated by LWR with Dor’s fundoplication after dissection of the seromuscular layer around the tumor
Summary
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Laparoscopic wedge resection (LWR) is being performed with greater frequency for the treatment of GIST of the stomach because it is less invasive than other procedures. We report a case of a gastric GIST at the EGJ that was successfully treated by LWR with Dor’s fundoplication after dissection of the seromuscular layer around the tumor. A gastroduodenal endoscopic examination revealed the presence of a submucosal tumor at the greater curvature of the EGJ (Fig. 1a). We performed LWR after laparoscopic dissection of the seromuscular layer around the tumor to prevent postoperative deformities and stenosis of the EGJ. Gastroduodenal endoscopic examination revealed no deformity or stenosis of the EGJ at 6 months after the operation (Fig. 4). When the GIST is located at the EGJ, postoperative complications that disturb food
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