Abstract: Objective: To explore the indications for total gastrectomy in treatment of cardiac carcinoma and the procedure of reconstruction of the digestive tract.Methods: Sixty-five patients with cardiac cancer underwent esophagus-jejunum Roux-en-Y reconstruction(RYR)(36 patients) or esophagus-jejunum tip-side anastomosis(TSR)(29 patients) after total gastrectomy.Results: Death in operation and anastomotic leakage occurred in no patients.The post-operative 1-year and 2-year survival rates were 58.5% and 35.4%,respectively.RYR group was better than TSR group in the intestinal volume and time in the intestine,also in the incidence rate of the reflux esophagitis.Conclusions: The patients with the advanced cardiac cancer are in good condition and the total gastrectomy surgical treatment should be employed actively.In addition,total gastrectomy is suitable for patients with small stomach or cardiac cancer following gastrectomy.Esophagus-jejunum Roux-en-Y reconstruction with better curative effect is better than esophagus-jejunum tip-side anastomosis.