Radical resection of carcinoma of the hyopharynx and cervical esophagus usually involves pharyngolaryngo-esophagectomy and esophaged reconstruction with stomach or colonic replacement. From 1983 to 1994, 139 patients underwent the operations in our hospital. Although no thoracotomy, the extensive involvement of the neck, thorax and abdomen in the operation made the anesthesia difficult. There were 66 patients whose blood pressure dropped more than 3 kPa in the course of trans-mediastinum extraction of esophagus and gastric pull-up. There were injury of posterior wall of trachea in 2 patients and spleen rupture in 3. However, no anesthetic complications occurred during the operation.