ObjectiveTo explore the influence of two-lung ventilation (TLV) plus artificial pneumothorax on patients with thoracoscopic esophagectomy.MethodTo analyze a retrospective study of 53 patients which were divided into the one lung ventilation (OLV) group and TLV group followed by thoracoscopic esophagectomy in the same hospital.The condition during operation, arterial blood gases and complications of both groups were compared.ResultsAll surgeries were completed without thoracotomy and laparotomy.There was no statistical significance of duration of operation, intraoperative blood loss, pulmonary infection and hospital stays between both groups (P＞0.05).The PaCO2 of T1,T2,T3 were higher than T1 which PaO2 was higher than the others.The PaO2 of T1,T2,T3 in TLV group were higher than that in control group.The PaCO2 of T2 and T3 in TLV group were superior to OLV group.PaO2 of T3 and T4 in TLV group were higher than OLV group (P<0.05).ConclusionTLV combined artificial pneumothorax is preferred for thoracoscopic esophagectomy with less complications and respiratory system dysfunction.