Surgery is the most effective treatment for esophageal cancer. Surgery is the preferred treatment for any resectable esophageal cancer. In the 70 years since Wu Yingkai first performed intrathoracic esophagogastric anastomosis for esophageal cancer in China in 1940, surgical treatment techniques have developed rapidly. The specific surgical procedures include partial esophagectomy or subtotal resection and two-field (thoracic and abdominal) or three-field (cervical, thoracic and abdominal) lymph node dissection, as well as the reconstruction of the esophagus after resection. Although scholars have different wishes, a relatively standardized treatment pattern has been formed, and esophageal cancer surgery has been popularized to city and county hospitals. However, the 5-year survival rate after surgery is generally only about 20%-30%. With the development of basic medicine and clinical medicine, and the in-depth understanding of esophageal cancer and its lymphatic drainage, the lateral drainage of esophageal wall and abundant longitudinal traffic branch drainage can lead to extensive lymphatic metastasis and jumping metastasis, and about 20%-30% of cervical lymph node metastasis still occurs after radical resection. In addition, there is a high chance of coexistence of simultaneous or heterochronic multipoint origin, satellite foci, subclinical foci and atypical hyperplasia foci of esophageal cancer. I have been transferred to the East Department of Thoracic Surgery (6th floor of the inpatient department) of Handan Central Hospital, and I mainly treat general thoracic diseases. In order to reduce the residual cancer foci and postoperative recurrence, after 1980s, some Japanese scholars and Shao Lingfang in China advocated that esophageal cancer should be treated by subtotal esophageal resection and three-field lymph node dissection, which is more traumatic and has more complications than conventional surgery, but its long-term efficacy is encouraging, with a 5-year survival rate of 40% to 50%. Surgical procedures can only remove limited tumor foci and lymphatic metastases, while for most advanced cases with extensive infiltration and metastases, additional comprehensive treatments such as radiotherapy, chemotherapy, Chinese medicine treatment and immunotherapy are needed, and individualized and reasonable comprehensive treatment plans are emphasized according to the patient’s systemic and local conditions to improve resection rate, long-term survival rate and quality of life. With the rapid development of science and technology, the accumulation of experience in surgical treatment, as well as the progress of anesthesiology, the update of instruments and drugs, and the application of comprehensive supporting measures such as the improvement of perioperative and monitoring conditions, new technologies and methods are adopted in a timely manner to promote surgical treatment to further expand the scope of surgical treatment selectively to the elderly, late cases, cases with medical complications and recurrence after radiotherapy. At the same time, we should emphasize the follow-up treatment of patients after discharge, tracking and monitoring the whole process, and planning rehabilitation treatment to improve the overall efficacy of esophageal cancer treatment.