The anastomotic fistula of cervical, thoracic and abdominal incisions is not in the thoracic cavity, so once the fistula occurs, the chemical and bacterial inflammation will not affect the whole body as in the case of thoracic fistula, and the treatment does not require fasting, keeping the cervical incision drained smoothly, and it can heal by itself after 1-2 weeks of drug exchange. The use of delayed removal of the gastric tube and intraoperative placement of the duodenal nutrition tube for early postoperative nutrition makes it more comfortable to handle. If serious complications other than anastomotic fistula occur, it is also beneficial to manage them. It is generally believed that this procedure is very traumatic and has many complications, however, other procedures such as the left thoracic “all incision” and the left cervical and thoracic “two incisions” use a large posterior lateral incision and require incision of the diaphragm at the same time, although there are fewer incisions, the actual trauma is greater. In order to improve the safety of the “three-incision” operation and reduce the surgical mortality, the following points must be noted: 1. Blunt separation, intrathoracic esophagus pulled out from this gap, as far as possible to avoid pulling hook traction, suspected nerve or vascular tissue should be avoided to cut, basically can not damage the recurrent laryngeal nerve; 2, cervical anastomotic fistula broken into the thoracic cavity is also a more serious complication, take the free stomach lifting up to the left part of the neck more, and use the left cervical muscle membrane and the right upper mediastinal pleura and stomach suture fixed to make the upper thoracic mouth closed, can eliminate this complication 3. The method of keeping the alternative organ stomach “loose at both ends and tight in the middle”, that is, the stomach is tight in the chest and loose in the neck and abdomen can prevent anastomotic fistula and gastric dilatation and pyloric insufficiency; 4. Such patients often have intestinal insufficiency or even intestinal obstruction after surgery, so it is very convenient to use the epigastric median incision to deal with the abdominal situation, and the perigastric adhesions, especially those around the pylorus, must be fully freed; 5. Group surgery can shorten the operation time, use bronchial intubation anesthesia, avoid extrusion of the lungs to reduce pulmonary contusion and interstitial pulmonary edema, which are all helpful to prevent pulmonary complications. The advantages of “three-incision” surgery: 1. 80% of the total length of the esophagus is resected, the chance of regenerating cancer in esophageal tissue is greatly reduced, and the recurrent cases are mainly lymph node metastases; 2. 4.Because the replacement organ stomach can be incorporated into the esophageal bed, it almost does not affect the expansion of the lung, and at the same time reduces the occurrence of thoracic gastric syndrome such as gastric dilatation, the amount of pleural effusion is small and the incidence is low; 5.No need to cut the diaphragm, no diaphragmatic hernia occurs, and also reduces the impact on respiratory function because of diaphragmatic incision; 6.It is beneficial to the cervical, thoracic and abdominal lymph nodes Although the incidence of anastomotic fistula was higher than that of intrathoracic anastomosis, the mortality rate was low and there was no surgical death in this group.