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Introduction Esophagectomy for treatment of squamous esophageal carries significant morbidity and mortality. Evidence suggested that occurrence of complications correlated with tumor recurrence and survival. Our study aimed to investigate the effect of technical complications on survival after esophagectomy for treatment of squamous esophageal cancer.MethodPatients who had esophagectomy for treatment of squamous esophageal cancer were recruited. Technical complications were defined as:1.anastomotic leakage; 2. Conduit ischemia; 3.vocal cord palsy; 4.wound infection; 5.chylothorax and; 6. Postop hemorrhage. The demographics, tumor staging, perioperative outcomes and 5 year survival were compared between patients with and without technical complications.ResultsFrom 1993 to 2008, 171 patients with squamous esophageal cancers were treated with esophagectomy and 66 survived for 5 year (38.6%). Majority of the patients were stage II and stage III diseases (7 Stage I (4.1%), 71 Stage II (41.5%); 68 Stage III (39.8%); 24 Stage IV (14%)). The overall complication rate was 38.6%, and technical complications occurred in 31 patients (18.1%) including: 11 anastomotic leakage (6.4%), 3 chylothorax (1.7%), 2 postop hemorrhage (1.1%), 9 vocal cord palsies (5.2%) and 6 wound infection (3.5%). Patients with technical complications had a higher 30 days mortality than those without (16.1% vs 5.7%; p = 0.062). The occurrence of technical complication does not affect the 5 year survival (p = 0.67, OR 1.18 (95% CI 0.54-2.62))(Log rank test p = 0.88). Moreover, there was no difference in tumor recurrence between those with or without technical complications (p = 0.073)ConclusionsThough patients with technical complications after esophagectomy had a higher 30 days postoperative mortality, this did not affect the overall 5 year survival and tumor recurrence.