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September 1949


Author Affiliations

From the Surgical Service, Veterans Administration Hospital, Hines, Ill., and the Department of Surgery, University of Illinois College of Medicine.

Arch Surg. 1949;59(3):734-741. doi:10.1001/archsurg.1949.01240040742033

IT WAS not many years ago that a famous American surgeon made the statement that carcinoma of the esophagus is beyond the realm of surgical therapy. It is only in recent years that malignant lesions of the cardiac end of the stomach which have invaded the lower esophagus have been completely removed by operative means. The surgeon is indebted to the tremendous advances in anesthesiology and to progress in the field of antibiotics for his opportunity to attack such lesions. They have enabled him to open the chest and mediastinum, considerably diminishing the serious dangers with which he formerly was confronted. The availability of blood in quantities sufficient to replace losses as they are encountered diminishes the danger of hemorrhagic shock. Although these advances have made transthoracic procedures on the stomach and esophagus justifiable, such operations still carry a high mortality and morbidity. Several factors are contributory. Most patients who

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