Between 1977 and 1980 55 in-patients were treated for oesophageal carcinoma. Tumour stage and general state permitted curatively aimed treatment in only 19 patients. Combined pre-irradiation and operation were the treatment of choice in these cases. Subtotal oesophageal resection and reconstruction were performed in one session. The stomach was used as replacement organ in all cases. In five cases with cervical or immediate supracardial tumour localisation the oesophagus could be extirpated by bimanual dissection without thoracotomy. Fourteen patients required surgery in both cavities. In nine out of the remaining patients, in whom only palliative surgery could be performed, retrosternal tumour bypass with the stomach was performed. During admission, lasting on average 17 days after the operation in 28 patients, three patients with resection and one with bypass died. In the other 24 patients operation led to normal ability to swallow.