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Objective: This paper discusses the differences between transthoracic approach and transabdominal approach in patients with Siewert types Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG), and aims to choose an ideal surgical approach for patients with Siewert types Ⅱ and Ⅲ AEG.Methods: Clinical data of 466 cases of patients with types Ⅱ andⅢ AEG (382 male and 84 female) were retrospectively analyzed.The selected patients had undergone surgery in 2004 to 2007in the Fourth Affiliated Hospital of Hebei Medical University.