Anastomotic stricture is a common condition after esophageal surgery. After esophagectomy, the esophagus needs to be reconnected to the stomach, colon or small intestine so that the integrity of the digestive tract can be restored. The esophagus-gastric is the most common connection, due to the best blood supply to the stomach and the simplicity of the operation, which has a high success rate. However, the chance of anastomotic stricture after esophagogastric anastomosis is significantly higher than that of intestine-to-intestine anastomosis. Why is this? This is mainly because 1) the dilatability of the esophagus is weaker than that of the intestine; 2) more importantly, the esophagus takes on the task of swallowing and the food is actively and rapidly moving down in this section of the digestive tract, whereas after the stomach it is slow and passive, so the feeling of “stricture” is more obvious in the esophageal stage. How many anastomotic strictures are there after esophageal cancer surgery? The incidence is generally reported to be between 15% and 40%, but the results in our hospital are slightly better, around 10%. The definition of anastomotic stricture is vague, and there is no uniform scale to measure it. Some people classify it by the type of food eaten, such as no way to eat a common food (e.g. rice) and define it as stenosis, while others measure it by whether the gastroscope is passable or not. In any case, I think the patient’s subjective feeling of eating is the most important. Anastomotic stenosis is inevitable, but recently we have used the most advanced techniques of end-lateral anastomosis, and posterior wall lateral + anterior wall end-lateral anastomosis, and the incidence of anastomotic stenosis has been reduced. Stenosis should be treated early after it occurs. Anastomotic stenosis can appear as early as 4 weeks after surgery and is most evident mostly at 3 months. The earlier the dilatation intervention, the more improvement can be obtained in as short a time as possible. Anastomotic stricture dilation usually requires 4-6 consecutive dilation sessions, each 1-2 weeks apart. Improvement is achieved in the vast majority of patients.