Abstract: [Abstract] Objective  To investigate the application of videoassisted thoracoscopic（VATS）esophageal replacement with colon（ERC）for  carcinoma.Methods  100 cases of esophageal carcinoma treated with surgery.The patients was randomly divided into two groups.Group A（n=49）underwent thoracoscopic esophageal replacement with colon.Group B（n=51）underwent videoassisted thoracoscopic esophageal replacement with colon.The mortality and incidence of complications such as anastomotic fistula，colonicischemia，necrosis，respiratory failure were compared.Results  The incidence of respiratory failure caused by postoperative infection in group B（0.02%）was lower than that in group A（16.3%）（P<0.05）.There was no significant difference in anastomotic fistula（3.9% vs 12.2%），ischemic necrosis of colon（0.02% vs 6.12%）and intestinal obstruction（0.02% vs 4.1%）between group B and group A（P>0.05）.The rate of postoperative complications（13.7% vs 40.8%）and mortality（5.9% vs 20.4%）between group B were lower than those in group A（P<0.05）.Conclusion The total complication rate and mortality rate of esophagus replacementwith colon under thoracoscopy are significantly reduced.