REMOVAL of the thoracic portion of the esophagus requires a long, tedious and shocking operation. In the postoperative period patients on whom this operation is performed are likely to have considerable pain and are subject to the many hazards of the operation as well as to other hazards which are concomitant and directly related thereto. These include especially pulmonary emboli and atelectasis. All complications which develop in these patients are likely to be particularly severe because of the poor nutritional condition in which they almost invariably present themselves.
For many reasons, pulmonary complications are particularly prone to develop and the patients are likely to have considerable difficulty in raising mucus, which seems to accumulate in especially large amounts in the tracheobronchial tree after esophagectomy. Experience indicates that the higher the level at which the esophagus is dissected, the larger is the amount of mucus that is likely to be present.