From the first cervical resection, by Czerny (1877), to the first successful thoracic excision by Torek (1913), several surgeons in the world, and especially Tuffier in France, experimented on the dog and studied respiratory consequences of thoracotomies. But all esophagus resections in men were mortal. Torek's operation had a high mortality rate, a very rare long-time survival with the double infirmity of a cervical esophagostomy and a gastrostomy. From 1933 (Oshawa) to 1945 (Sweet), a left thoracotomy with phrenotomy was performed. Immediate anastomosis was preferred by most surgeons. Mortality rate was high and only about fifteen operations in the world were successful. After World War II, two international conventions, in the USA in 1946, and in France in 1947 (Santy, Mouchet), noted important progress. It was less due to the surgeons' dexterity than to the development of modern anaesthesia procedures (tracheal intubation; curare; assisted ventilation; closed circuit devices). Abdominal and right thoracic approach, the royal way allowed spreading the resections to the carcinoma of the middle esophagus. After 1953, the devices of mechanical ventilation entailed indirectly the creation of respiratory, then polyvalent units. Independent anesthesiologists and reanimators entered the team. During the period 1960-1978, an era of statistical and better selection opened. The right approach emerged. But chiefly one notes major improvements of the instruments, needles, absorbable thread, mechanical tubulisation of the stomach, etc. Progress in flexible endoscopy and imagery (echography, Scan) allowed for better selection of patients for carcinoma resection. Radiotherapy, a more efficient chemotherapy and endoscopic intubation were employed in therapeutic decisions that had become increasingly multidisciplinary. After the battle and the victory of mechanical anastomosis, resection without thoracotomy and possible video-assisted esophagectomy concludes this historical survey, although probably only temporarily.
