Abstract: Objective:To investigate the causes and treatment of anastomotic leakage after resection of esophageal carcinoma.Methods:3815 cases of esophageal and cardiac cancer were treated by operation.320 cases of anastomotic leakage were diagnosed after operation，and the causes and related factors of anastomotic leakage were analyzed.According to the conservative treatment of anastomotic leakage，they were divided into 2 groups：the internal drainage group（endoscopic direct drainage under the drainage tube），and the external drainage group（closed thoracic drainage）were 38，282 cases，respectively.The time of extubation，the time of hospitalization and the mortality in the perioperative period were compared between the two groups.Results:The incidence of anastomotic leakage after esophageal cancer resection was 8.39%，and the mortality was 1.88%.Anastomotic leakage was related to age，location of anastomotic position，average gastric flow of 3 days after operation（P＜0.05）.The extubation time[（23.50±18.64）d vs.（30.60±14.08）d] and hospitalization time [（32.45±20.60）d vs.（54.12±25.08）d] of the internal drainage group were significantly shorter than those of the external drainage group （P＜ 0.05），and there was no significant difference in the mortality rate （0 vs.2.13%）（P＞0.05）.Conclusion:The incidence of anastomotic leakage in patients with younger than 60 years，Inferior anastomosis of the aortic arch and more average gastric flow of 3 days after operation was low.The placement of internal drainage through the fistula in endoscopic vision can rapidly improve the symptoms，shorten the extubation and hospitalization time，and is worthy of popularization.

Key words: esophageal cancer, anastomotic leakage, treatment