Until 1938 when Phemister and his associates1performed the first successful transthoracic resection for carcinoma of the lower end of the esophagus invading the cardia, the prospect of treatment of this disease was dismal if not hopeless. In the majority of cases in which the tumor involved the midthoracic segment, the application of the Torek procedure2resulted in disappointment because of the failure of this operation to provide satisfactory palliation and its inefficacy as a method of controlling the disease.3 As a result of several years of experience with resection and primary anastomosis within the thorax, the entire situation has changed, and the immediate and late results of treatment by resection and primary esophagogastric anastomosis may be evaluated. The elimination of the distressing dysphagia provided by this operation has been most gratifying, and the fact that a recurrence of the tumor at the site of anastomosis is