Abstract Among twenty-two patients who have undergone total gastrectomy with Hunt-Lawrence jejunal pouch and Roux-en-Y esophagojejunostomy, eight have survived from three to five years without evidence of recurrence of their primary disease. These patients have been carefully evaluated. Their ability to gain and maintain weight, to eat abundantly in comfort, to return to their preoperative work and physical activities, and to be free of dumping, diarrhea, and severe dietary restrictions has been significantly better than in patients with other types of alimentary reconstruction which we have used after total gastrectomy. Five of this group have gained 13, 14, 27, 35, and 44 pounds, respectively, since discharge from the hospital. Details of clinical follow-up and metabolic appraisal are presented.