ABSTRACT
Objective To evaluate a new surgical approach for the treatment of carcinoma of the gastric cardia. Methods The GI stapler was used to perform intramediastinal esophagogastrostomy for cardial carcinoma in 89 cases and esophago-jejunostomy in 16 cases undergoing total gastrectomy by the transabdominal approach with incising the crus dextrum of the diaphragm. Results The average length resected of the lower part of the esophagus was over 7 cm. Intramediastinal lymph node metastasis was found by pathology in 209% (22/105).There was no operative mortality and the morbidity rate was 476%, 5 year survival rate was 39%. Conclusions The technique enables lymphadenectomy within the lower mediastinum and a sufficiently long enough resection of the esophagus. Transabdominal incision of the crus dextrum of the diaphragm makes a clear operative field for the purpose of radical operation for carcinoma of the gastric cardia. The anastomosis by GI stapler effectively prevents anastomotic leakage.This procedure is indicated for cardial carcinoma cases in which the esophageal involvement is within 2 cm.