TWENTY years have elapsed since Ohsawa1(cited by Bird2) first successfully resected the esophagus for carcinoma and reestablished gastrointestinal continuity, a procedure introduced into this country by Adams and Phemister3in 1938. Limited at first to resection of carcinoma of the gastric cardia and to lesions of the lower esophagus, the range of operability was markedly extended in 1944 by Garlock,4who suggested transplantation of the esophagus above the arch of the aorta and the establishment of an anterior anastomosis between the stomach and the esophagus. As would be expected, the main surgical interest during these years was focused upon problems of operative technique. Due chiefly to the extensive experiences of Garlock,5Sweet,6Strieder,7Payne and Clagett,8and others, certain technical details have become established and the operative hazards decisively lowered, the net result being an increase in the resectability rate accompanied