The surgeon should keep in mind certain anatomic differences of the esophagus, which make its management more difficult than that of the rest of the gastrointestinal tract. First, since the esophagus is not covered by serosa, the longitudinal and circular muscle layers tend to tear when sutured. Second, the esophagus, while at first appearing to extend well down into the abdominal cavity, tends to retract up into the thorax when divided from the stomach, leaving the surgeon hard pressed for adequate length. It should be mentioned, however, that if the exposure is inadequate, the surgeon should not hesitate to remove more of the xiphoid or to split the sternum with potential extension into the left fourth intercostal space. Adequate and free exposure must be obtained to secure a safe anastomosis.