The question of the surgical approach to tumors of the cardia has traditionally been the subject of much debate. Proximal gastrectomy preserves part of the gastric tissue, so patients eat more after surgery than after total gastric surgery, and it is natural for patients to think that it is always better to keep some stomach. However, since the cardia and vagus nerve are removed in proximal gastrectomy, patients are prone to postoperative reflux esophagitis, which is characterized by retrosternal burning pain, and some patients even have to undergo reoperation to remove the remnants of the stomach because they cannot tolerate this symptom. Therefore, in order to prevent reflux esophagitis, the trend is that more and more doctors choose to do total gastrectomy for their patients. Although reflux esophagitis is rare after total gastrectomy, the removal of the whole stomach affects the amount of food the patient can eat after surgery, and the diversion of food (no longer passing through the duodenum) also leads to impaired absorption of certain nutrients. Currently, we carry out a surgical procedure that significantly reduces the incidence of reflux esophagitis without removing the whole stomach. Based on our experience as well as articles from our peers, this surgical approach has clear advantages. Of course, the prerequisite is that the patient’s lesion is not too advanced and the subpyloric lymph nodes should be free of metastasis.