Abstract： Objective:To investigate the effects of different one-lung ventilation(OLV)regimens on elderly patients undergoing thoracoscopic radical resection of esophageal cancer.Methods:This study was a prospective study, a total of 80 patients with esophageal cancer who underwent thoracoscopic radical resection of esophageal cancer in department of cardiothoracic surgery, Lyuliang People′s Hospital of Shanxi Province from September 2019 to October 2021 were selected, including 51 males and 29 females, aged(65.86±8.73)years old, ranging from 45 to 80 years old.All patients were randomly divided into volume controlled ventilation(VCV)group and pressure controlled ventilation(PCV)group, 40 cases in each group.The two groups were compared at different time points[pre-OLV(T0), OLV30 min(T1), OLV 60 min(T2), OLV 90 min(T3)]respiratory indexes(Pplat, Ppeak, Pmean), blood gas indexes(PaO 2, PaCO 2), perioperative indexes(operation time, OLV time, extubation time), and incidence of postoperative complications. Results:At T1 and T2, the Pmean, Ppeak and Pplat of PCV group were lower than those of VCV group, and the differences were statistically significant( P<0.05). At T1, T2 and T3, PaO 2 in PCV group was higher than that in VCV group, and PaCO 2 was lower than that in VCV group, and the differences were statistically significant( P<0.05). The extubation time of PCV group[(12.90±3.75)min]was earlier than that of VCV group[(19.03±3.97)min], and the difference was statistically significant( P<0.05). The incidence of postoperative complications in PCV group[17.5%(7/40)]was lower than that in VCV group[40.0%(16/40)], and the difference was statistically significant( P<0.05). Conclusions:During thoracoscopic radical resection of esophageal cancer, PCV mode can reduce airway pressure and improve oxygenation level, with fewer complications and faster recovery.