The investigation has shown that the due level of blood supply of the wound surfaces of the organs being sutured, the obligatory absence of a strain, perfect technique of the proper manual putting the end-to-end type anastomosis and the rational placing of the transplant in the posterior mediastinum with a strictly vertical rectilinear orientation, without bends and rotation, allowed to get a smooth course in 98.8% of the operated patients. Incompetent sutures took place in 1.2% of cases. It was also shown that the anastomosis of choice might be an invagination variant of the applying of it having not only high degree of reliability, but also the marked antireflux properties. The dynamic endoscopic control with the correction of forming anastomosis during 2-3 months allowed minimization of possibility of the development of scary stenosis. The results obtained suggest that the problems of intrathoracic esophageal anastomosis in clinic have been solved.