THE FIRST SUCCESSFUL RESECTION OF THE THORACIC PORTION OF THE ESOPHAGUS FOR CARCINOMA

The resection of the thoracic portion of the esophagus for carcinoma has been one of the greatest problems of modern surgery. A number of careful investigators have declared their standpoint in this matter to be that operations for carcinoma of the esophagus should be undertaken only if the new growth is either high up near the neck or low down where an anastomosis with the stomach can be made, but that the growths in the middle portion of the esophagus are not removable. The reasons for excluding these cases from the realm of operative interference were, first, the inaccessibility of that portion of the esophagus which passes underneath the arch of the aorta, and, secondly, the danger of injuring the pneumogastric nerves which in that location branch in front of the esophagus like a plexus. Division of both pneumogastric nerves at a place before they reach the heart causes instant