The surgery of carcinoma of the esophagus has undoubtedly made an enormous progress during the last thirty years. This progress is particularly due to advances in anesthesia, resuscitation, postoperative care but in a larger part to the development of new techniques. Our own experience shows indeed that the Belsey approach is a favorable technique. In our opinion this approach is the base of significant increase in resection possibilities. Moreover, it permits a maximal extension of the resection and gives better prospects of reconstruction, with an acceptable mortality. For the patient, for whom no resection is possible, a bypass procedure can still be performed. this solution is preferred to the introduction of a tube, which is bad procedure with a mediocre quality of survival.