Purpose:To discuss which is the better mode of operation for esophageal carcinoma after radiation therapy. Methods:We divided 232 esophageal carcinoma patients into two groups (group A 116 patients and group B 116 patients) random. Operation mode of group A was posterolateral thoracotomy through the bed of sixth rib in right thorax, retrosternal replacement esophagus with stomach and left neck anastomosis or esophagus exteriorization. Correspondingly operation mode of group B was anterolateral thoracotomy through the intercostal space of fourth rib in right thorax, esophageal pouch replacement esophagus with stomach and left neck anastomosis or esophagus exteriorization. We analyzed the resection rate, the mortality rate, the duration of operation, the volume of bleeding and total incidence of complication in each group. Results:The resection rate was 100% in group A and 92.24% in group B ( P 0.05). Conclusions:Operation mode of group A is a better mode of operation for esophageal carcinoma after radiation therapy which is based on the resection rate, which is higher in group A than in group B and total incidence of complication which is lower in group A than in group B.