目的　探讨提高食管癌的手术切除率及降低手术死亡率和提高远期效果及术后生存质量的措施。方法　对 2 837例外科治疗的食管、贲门癌患者的手术情况及随访结果进行分析。结果　本组手术切除率为98 7% ,手术死亡率为 0 92 %。全组 3年及 5年生存率分别为 4 8 9%和 33 7%。肿瘤的分期 ,肿瘤浸润深度和淋巴结转移影响 5年生存率。术后以颈淋巴结转移较多 ,且多发生在术后 3年内。结论　重视“三早” ,适当扩大切除范围 ,手术前后的综合治疗有利于提高术后远期生存率 Objective To explore measures to improve the resection rate of esophageal cancer, reduce operative mortality and improve long-term outcome and postoperative quality of life. Methods The surgical status and follow-up results of 2 837 surgically treated esophageal and cardiac cancer patients were analyzed. Results The surgical resection rate was 98 7% in this group, and the operative mortality rate was 92%. The 3-year and 5-year survival rates for the whole group were 48 9% and 33 7%, respectively. Tumor staging, depth of tumor invasion, and lymph node metastasis affected 5-year survival rates. Postoperative cervical lymph node metastasis was more frequent and occurred within 3 years after surgery. Conclusion Pay attention to “three mornings” and appropriately expand the scope of resection. Comprehensive treatment before and after surgery is beneficial to improve postoperative long-term survival rate.