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January 1948


Arch Surg. 1948;56(1):34-47. doi:10.1001/archsurg.1948.01240010037005

"TO THE surgeon there are but three diseases of the esophagus: cardiospasm, diverticulum and scar stenosis. The only other common disease is carcinoma, in which he is helpless." These words were written by Hertzler1 in 1936, and the passing of a decade has made them no longer applicable. As a result of the tremendous advances in anesthesiology, in surgical technic and in the use of antibiotics, the thoracic cavity can be entered with greater safety. Lesions of the esophagus have become accessible, and carcinoma of the esophagus is now a surgical problem. It can be successfully treated if an early diagnosis is made. Any portion of the intrathoracic esophagus can be removed and an anastomosis made between the stump of the esophagus and the stomach or small intestine within the thoracic cavity. Such procedures are still formidable, however, and are accompanied with a high mortality, as is shown in

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