From Apr. 1979 to Dec. 1994, a total of 3,714 patients with thoracic esophageal carcinoma were surgically treated. As a standard operative procedure for thoracic esophageal cancer, cervical esophagogastrostomy was performed. While this operative procedure was rarely used (accounting for only 8.8% the treated cases) in early years, it has been recently carried out in the overwhelming majority of our patients (94.1%). This technic offers the advantages of resecting the lesions radically, dissecting the regional lymph nodes in both the neck and the mediastinum, reducing the incidence of postoperative complications and improving the quality of life after operation. In this paper the operative indication, approach and the surgical efficacy are discussed.