Elderly, poor cardiopulmonary function can not tolerate open thoracic or luminal surgery one-lung ventilation, can consider blunt esophageal debridement for the treatment of middle and early esophageal cancer. Li Jindong, Department of Thoracic Surgery, Henan Cancer Hospital, early esophageal cancer patients with combined chronic obstructive pulmonary disease and poor lung function are absolute indications. Patients with combined chronic obstructive pulmonary disease and poor lung function also tend to tolerate radiotherapy poorly. Radiation pneumonitis is unavoidable, and once it occurs it may result in the expected radiochemotherapy not being completed successfully and in sufficient quantity. Remember that it must be an intermediate- to early-stage esophageal cancer with no infiltration of the lesion with the peri-esophagus and no obvious calcified lymph nodes in the mediastinum. Ability to tolerate open thoracic or laparoscopic surgery Open thoracic or laparoscopic surgery is preferred. Anatomical basis for blunt dissection of the esophagus i: 1. The movable position of the esophagus in the loose connective tissue within the mediastinum and the absence of large surrounding blood vessels, nerves, or fibers binding it to the thoracic cavity. (Kiek 1974; Orringer,1983); 2. The length of the esophagus in the thoracic segment is about 20 cm, and it can be relatively easy to bluntly free it through the enlarged esophageal fissure and thoracic inlet, and the hand can feel the new meeting; 3. The small branches of the tiny and slightly longer arteries that distribute to the esophagus during blunt dissection are rat-tailed and thinned at the broken ends of the vessels during the tear, which makes the effect of constriction and hemostasis more desirable; the most dangerous part of the esophageal dissection is the chi vein and odd vein arch injury, leading to fatal hemorrhage. The key to freeing the