Stenosis often occurs after severe burns of the esophagus, and medication and esophageal luminal intubation have the effect of preventing the formation of scar stenosis, but there are few reports of good results in the prevention of scar stenosis with medication alone, and half of the patients develop scar stenosis again after esophageal luminal intubation. Esophageal dilatation has to be repeated several times, which is not easy for children to cooperate and may even cause esophageal rupture. In addition, according to the observation on the condition of the children with esophageal scar stenosis, not only the mucosa of the esophagus was eroded, but also the corresponding muscular layer and the surrounding loose tissues were involved, and the wall of the tube was stiff, which was difficult to be cured by esophageal dilatation; when the new trauma caused by mechanical dilatation was healed, the synthesis and deposition of collagen would form a new stenosis again. Therefore, for children with severe chemical burns of the esophagus, the author advocates active esophageal reconstruction, and we mostly adopt the transverse colon substitute esophagus surgery for the treatment of pediatric esophageal scar stenosis after chemical burns. The substitutes that can be used to reconstruct the esophagus include stomach, jejunum and colon, etc. However, the change of the position of the stomach will destroy the normal physiological function, and it is easy to reflux after the operation, besides, some of the children’s stomachs are also burned at the same time; the jejunum blood vessels are in a multilevel network, and the intestinal segments are in the form of collaterals, so the failure rate of the operation is high; the colonic substitution of the esophagus is in line with physiological conditions, and the impact on the cardiorespiratory function is small, with a high success rate, which is already agreed by the majority of scholars. According to the observation of this group of cases, the middle colonic artery is more variable, with different patterns such as “T”, “Y”, “V”, “orchid” and so on. “The right colonic artery and its mesentery were shorter, with more vascular variation, and lacked an anastomotic arch between some individuals and the middle colonic artery or ileocecal artery; the left colonic artery was relatively constant, and the anastomotic arch between the left colonic artery and the middle colonic artery was adjacent to the bowel, and the anastomotic arch of the left colonic artery was poorly developed in a very small number of children, and there was often a l left-side paracolic artery anastomosing with the ascending branch of the left colonic artery. Anastomosis. The transverse colon has sufficient length, is an interperitoneal organ, has strong acid resistance, is easy to free and can be anastomosed in the direction of peristalsis, and does not injure the vagus nerve when freeing, so gastrointestinal function recovers quickly. For this group of children, we pay attention to the colo-gastric anastomosis as close as possible to the bottom of the stomach, away from the strong peristalsis of the gastric sinus, the anastomosis is about 2/3 of the inner diameter of the intestinal lumen, in order to prevent the occurrence of postoperative reflux. Occasionally, a small amount of reflux after a full meal is advised to have a small number of meals, do not lie down after meals, oral gastric dynamics can be relieved.