A cardioectomy is the surgical removal of the cardia, which is the upper portion of the stomach where it connects to the esophagus. Despite the “cardio” prefix, this procedure does not involve the heart. The cardia is a small region of the stomach named for its proximity to the heart, which sits just above it, separated by the diaphragm.
The Cardia of the Stomach
The stomach has several distinct regions, and the cardia is the first one food encounters after leaving the esophagus. It sits at the gastroesophageal junction, the point where the tube from your throat meets the top of the stomach. This region contains a ring of muscle fibers that helps prevent stomach acid from flowing backward into the esophagus.
The cardia is relatively small compared to the rest of the stomach. Below it sits the fundus (the rounded upper dome), then the body (the largest section), and finally the pylorus (the lower exit leading to the small intestine). The cardia’s name comes from the Greek word “kardia,” which originally meant both “heart” and “stomach opening,” because early anatomists noticed how close these two structures sit to each other in the chest and upper abdomen.
Why a Cardioectomy Is Performed
The most common reason for removing the cardia is cancer. Tumors that develop at the gastroesophageal junction or in the upper stomach often require removal of this region to eliminate cancerous tissue and a margin of healthy tissue around it. Adenocarcinoma of the gastroesophageal junction has become increasingly common in recent decades, particularly in Western countries, and surgical removal of the affected area remains a primary treatment approach.
In some cases, severe precancerous changes in the cardia, chronic ulceration that hasn’t responded to other treatments, or trauma to the area can also lead to surgical removal. The procedure may be performed on its own or as part of a larger operation. When a surgeon removes the upper portion of the stomach including the cardia, the procedure is sometimes called a proximal gastrectomy, with the cardioectomy being one component of that broader surgery.
How It Differs From Related Procedures
Medical terminology in this area can be confusing because several similar-sounding procedures exist. A total gastrectomy removes the entire stomach. A partial or subtotal gastrectomy removes a large section, typically the lower portion. A cardioectomy is more targeted, focusing specifically on the cardia at the top of the stomach.
It’s also worth distinguishing cardioectomy from cardiac surgery. Procedures involving the heart use terms like “cardiotomy” (cutting into the heart) or specific names for the operation being performed, such as coronary artery bypass. A cardioectomy, with its “-ectomy” suffix meaning “to cut out,” refers exclusively to removing the stomach’s cardia.
What Happens After Removal
After the cardia is removed, the surgeon reconnects the esophagus to the remaining stomach tissue. This new connection is called an anastomosis. Because the natural valve mechanism between the esophagus and stomach is lost, people who have had a cardioectomy often experience acid reflux more easily than before. Eating smaller, more frequent meals and staying upright after eating can help manage this.
The stomach is remarkably adaptable. Even with the cardia removed, the remaining portions continue to break down food and move it into the small intestine. Digestion still functions, though some people find they need to adjust their eating habits permanently. Nutrient absorption can be affected over time, so ongoing monitoring of vitamin and mineral levels, particularly B12 and iron, is typical after any surgery that reduces stomach size.