To summarize the innovation of the key technique of laparoscopy of esophagectomy with thoracoscopy and laparoscopy, and investigate its safety, reliability and feasibility.

For the pathological staging, 4 cases were at stage Ⅰ, 16 cases stage Ⅱ, 22 cases stage Ⅲ and 1 case stage Ⅳ. There were 12 cases of upper thoracic esophageal carcinoma, 23 cases of middle thoracic esophageal carcinoma and 8 cases of lower thoracic esophageal carcinoma. The clinical outcomes were observed, and the key points of technique innovation, such as double-direction stomach mobilization, no-touch stomach mobilization, subxiphoid minimal invasion, and thoracic segment esophageal tumor-free thoracoscopic resection were summarized.

There was no perioperative mortality, chest abdominal cavity and incision metastasis, tubular gastric fistula and necrosis, delayed gastric emptying, abdominal incision infection and splenic injury. Conversion to open surgery occurred in 1 case (2.3%) due to tumor invasion, pulmonary infection happened in 6 cases(14.0%), and anastomotic fistula took place in 1 case(2.3%). The mean abdominal operation time was (59.65±18.10) min, the mean volume of blood loss was 40 ml (15 to 100 ml), the mean maximum diameter of lesions was 5 cm(1 to 11 cm), the mean abdominal lymph node number was 7 (2 to 24), the mean duration of ICU stay was 18 h(10 to 40 h), and the mean postoperative hospital stay was 11 d(8 to 28 d).

Innovation of the key technique of laparoscopy of the esophagectomy with thoracoscopy and laparoscopy is safe, effective, convenient and easy to learn.