目的总结食管癌术后死亡率,对比分析不同时期食管癌术后死亡原因构成差异,探讨食管癌术后死亡危险因素及相互关系。方法回顾性分析经外科手术切除食管癌3 284例,按年代统计,将前32年(1954年1月~1985年12月)和后22年(1986年1月~2008年3月)分为A、B两组,并就其术后早期死亡128例原因进行探讨分析。结果A组早期术后死亡44例,死亡率为8.15%(44/540)。B组84例,死亡率为3.06%(84/2 744)。A组首要死亡原因为术后特殊并发症,其次为重要脏器衰竭;B组首要死亡原因为重要脏器衰竭,其次为术后特殊并发症。结论食管癌术后死亡原因构成比例的变化与食管癌根治术日趋成熟及手术适应证逐渐扩大有关,多种危险因素并存将是未来导致食管癌术后死亡的主要原因。 Objective To summarize the postoperative mortality of esophageal cancer and compare the causes of postoperative death caused by esophageal cancer in different periods and to explore the risk factors of postoperative esophageal cancer death and their correlation. Methods A retrospective analysis of 3 284 cases of surgically resected esophageal cancer was performed. According to the age statistics, the former 32 years (January 1954 to December 1985) and the latter 22 years (January 1986 to March 2008) were divided into A, B two groups, and its early postoperative death of 128 cases were analyzed. Results A group of early postoperative death in 44 cases, the mortality rate was 8.15% (44/540). B group 84 cases, the mortality rate was 3.06% (84/2 744). The main cause of death in group A was postoperative special complication, followed by vital organ failure. The main cause of death in group B was vital organ failure, followed by special complication after operation. Conclusion The change of the proportion of postoperative death causes of esophageal cancer is related to the maturation of esophageal cancer and the gradual expansion of surgical indications. The coexistence of multiple risk factors will be the main cause of postoperative death of esophageal cancer in the future.