本科１９８０年１月～１９８５年２月施行食管癌切除颈部食管胃吻合术１８７例，发生吻合口瘘４１例（２１９２％），死亡８例（８／４１）。１９８６年１月～１９９７年１２月作同样手术４３８例，发现吻合口瘘７例（１５９％），无１例死亡。本文分析发生吻合口瘘和死亡的原因。认为降低吻合口张力、保证充分血运和控制术后剧烈咳嗽可以降低吻合口瘘发生率，及时，充分引流，防止瘘液逆流入胸腔纵膈可降低瘘后死亡率 From January 1980 to February 1985, 187 cases of cervical esophagogastric anastomosis of esophagectomy were performed. 41 cases (21.92%) of anastomotic fistulas occurred and 8 cases (8/41) died. From January 1986 to December 1997, 438 patients underwent the same surgery. Seven cases (159%) of anastomotic fistulas were found and none died. This article analyzes the causes of anastomotic leakage and death. It is believed that reducing the anastomotic tension, ensuring adequate blood supply, and controlling postoperative severe cough can reduce the incidence of anastomotic leakage, promptly and fully drain, prevent the reverse flow of sputum into the thoracic cavity and reduce the postmortem mortality.