The mid-century revolution in thoracic and cardiovascular surgery: part 3.

The esophagus has always taken third place in the minds and hearts of chest surgeons, whose primary interests were pulmonary and later on cardiac surgery. Indeed, the esophagus runs from the neck through the chest to below the diaphragm, and it was logical that ‘borderline’ pathologies such as diverticula, achalasia, and tracheoesophageal fistulas were also taken on by ENT surgeons as well as those interested in pediatric or gastrointestinal surgery. A sort of ‘no man’s land’, the esophagus was rapidly taken over by general surgeons once the problems of anesthesia, thoracotomy and postoperative care had been solved. Aside from the fact that topographically the esophagus belonged to the chest, there was indeed very little difference in the technique for operations of the esophagus, the stomach, or the colon, all the more as the latter viscera were used to reestablish the continuity of the alimentary tract. Thus, I could have hesitated to include the esophagus; but any historical analysis reveals again that most breakthroughs in this field were the doings of thoracic surgeons (Torek, Cameron Haight, Sweet, Belsey, and others). The dramatic story of the esophagus could be told in many ways and, having lived through all of it, I will tell it according to my somewhat personal experience. The spectacular advances are connected with three names: