Abstract: Objective: To explore the optimal surgical approach for treatmemt of advanced cardiac cancer.Methods: Twenty-two cases of carcinoma of gastric cardia were operated on by the approach of abdominal cavity and diaphragm.Median abdominal incision was adopted to all the cases.The stomach was dissociated conventionally,the diaphragma dissected from centrum tendineum front oesophagus and the encroached diaphragmu excised.Results: Of the 22 cases,1 case of anastomotic leakage was cured by nonoperative treatment and 1 case of celiac haemorrhage was cured by reoperation.No patients died during the operation;the average hospital stay was 14 days.Conclusions: The surgical approach is adapt to the cases whose carcinoma has encroached diaphragum or inferior oesophagus and the cases whose excision of surerior incisal margin is felt discontented.As the approach has no thoracic incision,the wound and syndrome of heart and lung is decreased.This approach is especially suited to the senior and high risk patients.