We have injected emulsion of activated carbon particles (CH 40), into the mediastinal lymph nodes at the bifurcation of trachea and examined whether carbon impregnated black lymph node is useful as a guide for more accurate and more appropriate lymphadenectomy at the esophagectomy. The patients subjected to our study were 112 patients with carcinoma of esophagus experienced from 1974 to 1991. Among them, 20 cases underwent 3-field lymph nodes dissection with CH 40 (CH group) and as control groups 41 cases received 2-field lymphadenectomy (2-F group), and 51 patients received 3-field lymphadectomy without CH 40 (3-F group). The average numbers of the lymph nodes dissected in CH group (24.5) was significantly larger in comparison with 2-F group (9.1) and 3-F group (10.5) (p < 0.05). The rate of the number of metastatic lymph nodes per number of lymph nodes dissected in the mediastinum in CH group (55.0%) was higher in those of 2-F group (24.3%) and 3-F group (33.3%). Postoperative pulmonary complications were observed in 20% in the of CH group, but in 41% of 2-F group and 60.0% in 3-F group. Cumulative 3-year survival rate in CH group was better than others. Therefore, it was concluded that the 3-field lymphadenectomy with CH group was useful in the operation of the carcinoma of the esophagus to improve the prognosis and decreasing the postoperative pulmonary complications.