Total gastrectomy has more frequent and serious postoperative complications than subtotal gastrectomy. An esophago-gastric stoma with a side-to-side anastomosis permits a near-total gastrectomy to be undertaken with virtually the same results as a total gastrectomy. This procedure is used for early gastric cancers that have widely spreading, single or multiple lesions, or lesions near the esophago-gastric junction, and for the cure or palliative resection of selected patients with advanced gastric cancer.