A patient with G.E.R. was treated (Nissen plus reduction of the hiatus). Stenosis of the esophagus and achalasia was demostreated in the postop. Miotomy and new funduplasty were performed. Severe esophageal obstruction was produced multiple dilatations were done. The patient was refered for treatment after clinical tests the diagnosis was: Severe recurrence of obstruction of distal esophagus Surgical treatmen was indicated: Distal resection of the esophagus and left colon interposition. After Clinical records the movie stars with x-ray swallow and endoscopy. Middle line laparotomy was performed. Disection of the hiatus. Mobilization of the affected asophagus (diameter 5 cms), and funduplasty. Vagus nerves were preserved distal esophagus and fundus were resected. TA 45/90 were used. Splenic flexura of the colon was mobilized and Riolano arcade and Inferior Mesenteric Artery and vein preserved. The colon was interpose between the esophagus and stomach. End-to-end esophago-colostomy. End-to-side colo-gastrostomy abd finally colo-colostomy. Posoperative follow-up with x-Ray swallow and endoscopy.