An experience with 139 radical one-step surgeries for esophagus cancer using transpleural or transmediastinal plasty with a gastric tube is presented. This type of surgery is a method of choice for malignant tumours of the esophagus since it provides the best radical operation and good functional results. The standardized approach to the anesthesiological maintenance of these surgeries and to postoperative intensive therapy is substantiated. The total postoperative mortality made up 26.2%; mortality from surgical complications-20.9%; 3-years survival was 24.5%; 102 patients (73.3%) were discharged from the clinic with good functional results.