Predictors of difficult endoscopic resection of submucosal tumors originating from the muscularis propria layer at the esophagogastric junction

Figure 1 The procedure of submucosal tunneling endoscopic resection. A: Endoscopic view of the tumor; B: Endoscopic ultrasonography view of the tumor; C: The submucosal tumor exposed using the submucosal tunnel technique; D: Endoscopic view of the submucosal tunnel after the tumor was removed; E: The mucosal entry closed by clips; F: The piecemeal resected tumor.

Figure 2 Case illustration of endoscopic full-thickness resection. A: Endoscopic view of the tumor; B: Endoscopic ultrasonography view of the tumor; C: The submucosal tumor exposed by full-thickness resection; D: The wound surface after removal of the tumor; E: The gastric wall defect was closed with endo-clips; F: The horseshoe-shaped specimen.

Figure 3 Tumor size. A: There was a significant negative correlation between age and tumor size; B: Tumor size at different ages in the submucosal tunneling endoscopic resection group, endoscopic full-thickness resection group and endoscopic submucosal dissection group are shown. The circle dots above the horizontal line represent tumors larger than 4 cm. STER: Submucosal tunneling endoscopic resection; EFTR: Endoscopic full-thickness resection; ESD: Endoscopic submucosal dissection.