Inclusion Criteria:  Histologically proven primary intrathoracic middle and lower esophageal squamous cell carcinoma and will undergo McKeown MIE and bilateral RLN lymph ndoe dissection. No superclavicular lymph node metastasis after preoperative examination. No contraindication for esophagectomy. Expected surgical R0 resection.  Exclusion Criteria:  Pre-existed vocal cord dysfunction. Thorax pleural adhesion rendering minimal invasive approach unfeasible. Gastric tube cannot be used for reconstruction. Combined with hemorrhagic disease. Psychiatric patients. Inability to undergo curative resection and/or follow-up.