Abstract: ObjectiveTo estimate the effect of single-lumen and double lumen tracheal intubation on mediastinal lymph node dissection in esophagectomy by video-assisted thoracoscopy（VATS）. Methods Clinical data of One hundred and thirty-seven esophageal cancer patients from July 2011 to January 2015 underwent esophagectomy with lymph node dissection by VATS were retrospectively reviewed. Seventytwo patients received artificial pneumothorax and single lumen tracheal intubation were set as experimental group，and 65 patients received double lumen tracheal intubation were in control group. The effect and complications of the two groups were observed. Results The operation time of experimental group was less than that of control group［（137.7±20.7）min vs.（163.8±27.3）min，P＜0001）］. The number of lymph node dissection in experimental group was more than that of control group（22.2±3.3 vs. 19.8±4.6，P=0.024）. The incidence of recurrent laryngeal nerve injury and pulmonary infection in experimental group was lower than those in control group （1.4％ vs.9.2％，P=0.037；2.8％ vs. 12.3％，P=0.032）. There was no statistical difference in postoperative hemorrhage，postoperative ICU days，hospitalization days，anastomotic fistula，chylothorax，pleural hemorrhage，wound infection，poor gastric emptying between the two groups. Conclusion Single lumen endotracheal intubation and artificial pneumothorax can increase the number of lymph node dissection，improve the quality of operation and reduce the incidence of complications.