To investigate the feasiblity and short-term effect of laparoscopic and thoracoscopic Ivor Lewis esophagectomy with transorally placed anvil(OrVil).

Methods Laparoscopic and thoracoscopic Ivor Lewis esophagectomy and esophagastric anastomosis were performed on 65 patients with esophageal cancer between January 2012 and December 2014. The anvil (OrVil?; Covidien, Mansfield, MA, USA) was placed transorally and positioned at the esophageal stump. The esophagastric anastomosis was performed intracorporeally with a circular stapler (EEAXL25 Covidien, Mansfield, MA, USA).

All the operations were successfully performed, with no intra-operative complications or transfer to open surgery. All the lesions located in the lower portion of the esophagus, with the mean length of 3.9 cm. The mean time for laparoscopy and thoracoscopy was 99 min and 160 min, respectively, and the mean blood loss was 300 ml. The patients were able to take meal from 5.8 d after operation. Postoperative pathologcial examinations revealed that there were 56 cases of esophageal sqnamous cell cancer and 9 cases of adenocareinoma, and there was no positive findings on the incision margin. The mean number of harvested lymph nodes was 15.6 from thorax and 6.9 from abdomen in each patient. There were 5 cases of incision infection and 1 case of chylothorax after operation, and all recovered by conservative therapy. Besides, there was no anastomotic leak after operation.

Laparoscopic and thoracoscopic Ivor Lewis esophagectomy with OrVil is mininally invasive with fast recovery, and is feasible and safe for the treatment of esophageal carcinoma to obtain a satisfactory short-term effect.