Results of 56 transhiatal esophagectomies performed for cardioesophageal cancer from 1985 to 1999 are evaluated. Operation was completed by one-stage plastic repair with gastric flap or colon. Manual transhiatal esophagectomy performed in 35 cases led to many intraoperative complications in location of the tumor in the middle and top part of thoracic esophagus, including two fatal. These complications make manual transhiatal esophagectomy in this location of the tumor undesirable. Of it is indicated only in location tumor in the bottom third of the esophagus. In such cases instrumental transhiatal removal of the esophagus above the tumor is made. This method was used in 21 cases without intraoperative complications and lethal outcomes.