This is an account of preoperative preparation and fast-track rehabilitation protocol developed by the collective body of the P.A. Herzen Moscow Oncology Research Institute for patients during surgical treatment for thoracic esophageal cancer. Objective: to elaborate an optimal perioperative patient management protocol to reduce postoperative complications, mortality rates, and postoperative bed days without adverse effects to the patient. Based on his experience in treating patients with esophageal cancer, the author developed a perioperative management protocol for this category of patients. This algorithm was applied to 50 patients with carcinoma of the esophagus and cardia. In the study group, postoperative complications were stated in 12 (24%) patients, including surgical complications in 4 patients (chylothorax (n=2), esophageal-intestinal anastomotic incompetence (n=1), and small bowel obstruction (n=1). Nonsurgical complications in the absence of surgical ones were noted in 7 patients: pneumonia (n=6), cardiac arrhythmias as atrial fibrillation (n=1). A control respective group included 50 patients with the same surgical volumes, who underwent standard preoperative preparation. In the control group, postoperative complications were observed in 28 (56%) patients; 4 died. There were no deaths in the study group. The mean postoperative bed days were 11 (range 10-29) and 18. Conclusion: Our developed preoperative patient examination and preparation protocol allows a considerable decrease in the frequency of postoperative complications and deaths, reducing the length of hospital stay.