Objective：To investigate the clinical efficacy and prognosis of placing stapler anvil bottom through oral cavity under the thoracic laparoscopy in the treatment of esophageal cancer. Methods：Totally 100 patients with esophageal cancer in our department from January 2008 to January 2013 for surgical treatment were randomly divided into experimental and control group. The experimental group received oral anvil head system（OrVil） chest laparoscopic esophagectomy intrathoracic esophagogastric anastomosis. The con－trol group received traditional thoracotomy. The intra-operation and post-operation condition，lymph node dissection，postoperative complication rate and one-year follow-up were compared. Results：The operative time，blood loss，drainage on the first postoperative day，drainage tube indwelling time and postoperative hospital stay were significantly lower in experiment group than in control group（P<0.01）. There was no difference in the total number dissected lymph node，number of dissected lymph node group，and number of dissected thoracic and abdominal lymph node，P >0.05）. The short-term complication rate of experimental group was significantly lower than that of control group（P<0.05. There was no difference in postoperative recurrence or metastasis rate，death rate，anastomotic stenosis and regurgitation incidences between the two groups（P >0.05）. Conclusion：With fewer risk，lower complication rate and sim－ilar efficacy as traditional thoracotomy，placing stapler anvil bottom through oral cavity under the thoracic laparoscopy is worthy of clinical application