A malignant tumor at or near the junction of the esophagus and the stomach when operable is best treated by transpleural resection and esophagogastrostomy. Such an operation permits wide extirpation of the growth and the regional lymphatics and allows the patient later to swallow and pass food into the stomach in a normal manner. Since Voelcker1 in 1908 successfully performed esophagogastrostomy after abdominal resection of a carcinoma of the cardiac end of the stomach, the operation has been successfully performed in 21 additional cases. A good summary of the literature on the subject was published in 1938 by Adams and Phemister.2 In 1941 Garlock3 gave an account of his clinical experience with the problem. The procedure hereinafter reported follows closely the method described in 1940 by Carter, Stevenson and Abbott.4 In the past the operation has more often resulted in failure, with death from shock or