Total resection of the gastric tube with lymphadenectomy is standard and reliable treatment for gastric tube cancer. However the risk associated with totally removing a gastric tube previously reconstructed through the posterior mediastinal route is significant, given the need to lyse a significant number of adhesions in order to reach the mediastinum. As a less invasive procedure, we used distal gastrectomy to treat superficial gastric tube cancer in 2 patients. The distal gastric tube was mobilized and resected with preservation of the right gastroepiploic artery, and the Roux-en-Y gastrojejunostomy was used for reconstruction. This procedure was curative with less surgical stress.