目的探讨胸段食管癌手术治疗的方法。方法92例胸段食管癌患者全部行右侧开胸全胸段食管切除、三野淋巴结清扫(3-FL)。结果食管癌沿食管壁内上行播散与下行播散差异有显著性,胸上、中、下段食管癌下颈野淋巴结转移率差异有显著性。结论胸下段食管癌,全胸段食管切除、二野淋巴结清扫(2-FL)可列为首选术式;胸中、上段食管癌,特别是胸上段食管癌,全胸段食管切除、三野淋巴结清扫(3-FL)应列为首选术式。 Objective To investigate the surgical treatment of thoracic esophageal cancer. Methods Thirty-two patients with thoracic esophageal cancer underwent total thoracotomy in the right thoracotomy and three-node lymphadenectomy (3-FL). Results There was a significant difference between upper and lower esophageal esophageal spreads in the esophageal wall, and there was a significant difference in the metastasis rate of cervical lymph nodes under the upper, middle and lower esophageal carcinomas. Conclusions The lower thoracic esophageal cancer, total thoracic esophagectomy and 2-FL lymphadenectomy (2-FL) may be the first choice. The upper and middle esophageal cancer, especially the upper esophageal cancer, the total thoracic esophagectomy and the three-node lymphadenectomy (3-FL) should be listed as the preferred surgical procedure.