602 patients had an operation on the cardia of stomach during 10-year period 1964-1973 in the Surgical Department of Kiel University. In total there were 395 operations without resection with a 9% postoperative complication rate opposite to 207 resections of the cardia with 38% complications. Here the primary lethality was 7% (14 patients). The complications of suture insufficiency and hemorrhage are demonstrated and their outcome checked up: 13 of 16 patients died of suture insufficiency (81%) and 8 of those 13 with hemorrhage (62%). Especially important for the successful treatment of suture insufficiency are early diagnosis, drainage of the area and closure of the leakage. A new technique of suture insufficiency treatment is reported: T-Drainage into the leakage. This has led to a lowering of the death rate.
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