Sufficient experience has been gained to establish resection of the esophagus with transthoracic esophagogastrostomy as the operation of choice for the treatment of patients with carcinoma of the lower thoracic esophagus. Results, both short- and long-term, have been good enough to establish this procedure as the standard method of treatment for cancers of this segment of the esophagus. Unfortunately, however, the results obtained by surgical extirpation of carcinoma of the upper thoracic esophagus have left much to be desired. Indeed, after resection of this segment of the esophagus with high esophagogastrostomy in the posterior mediastinum, the immediate mortality has been so high and the late results so poor that there seems to be a current tendency toward abandonment of any surgical approach to these lesions and toward preference for other methods of therapy, particularly irradiation. At the same time, there has recently appeared in the literature some enthusiasm for replacement