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[Surgical treatment of carcinoma of the stomach invading to the esophago-gastric junction].

In order to elucidate the clinico-pathologic features of gastric cancer invading to esophago-gastric junction and to discuss about rational surgical treatment, 111 cases during the 23-year period between 1957 to 1983 were selected. Of these patients, a total gastrectomy with lower esophagectomy or subtotal esophagectomy on 82 (74%), a cardiofundectomy on 26 (26%) and caudal hemipancreatectomy with splenectomy on 99 (89%) were carried out. It is severely impossible to eradicate primary tumor with an adequate margin of the esophagus and intrathoracic lymph nodes only by abdominal approach in resecting gastric carcinoma invading to esophago-gastric junction. Our experience emphasizes that a laparotomy with median sternotomy is ideal one, in addition, blunt dissection of the thoracic esophagus or right thoracotomy may be done if indicated.