In 26 patients with malignancies of the oesophagus or cardia and three with benign lesions the intrathoracic oesophagus was resected via abdominal and cervical incisions only and reconstructed with the stomach, a colon interposition or jejunal loop. The operation was chosen to omit the thoracotomy in patients with reduced tolerance to surgery or to secure a safe resectional margin in patients with easily resected tumours. With the exception of two patients, the method was not used for removal of mid-oesophageal tumours. Awareness of the possibility of intrathoracic complications such as bleeding into the pleural cavity is required during the procedure. A high mortality among the older patients contributed to a total mortality of 24%, indicating that the avoidance of a thoracotomy does not necessarily make the operation better tolerated, but it takes less time and postoperative morbidity is reduced.