Beschreibung:
Abstract Background Early radical resections are the main treatment methods towards esophageal squamous cell carcinoma (ESCC). Classic transthoracic esophagectomy (McKeown approach) could resect esophagus lesion as a whole piece, so the surgical results could be satisfactory and the regional lymph node dissection could be clean. With the maturation of video-assisted thoracoscope in thoracic surgeries, good vision, subtle operating system, and mature operating technologies have made the multi-portal thoracoscopic minimally invasive laparoscopic esophageal resection more and more mature. Meanwhile, SPVATS gradually appeared, which was firstly used in simple thoracic surgeries, and further applied to lung and mediastinal tumor resection; relevant summaries have been reported, and the feasibility of SPVATS for standard mediastinal lymph node dissection was also further verified.The application of SPVATS towards TESCC has also been gradually carried out. Would minimally invasive esophagectomy be safe? Whether SPVATS could be used in the McKeown approach for TESCC? Whether SPVATS could safely resect esophagus, and perform standard dissection towards local esophageal region and mediastinal lymph nodes, as well as avoid damaging the surrounding organs and tissues? Some scholars had compared SPVATS and multi-portal VATS in treating medio-inferior TESCC. Methods METHODS: 25 McKeown approach-based SPVATS surgeries (19 males and 6 females, aged 42–70years) were carried out from January 2015 to December 2017 to treat TESCC, including 2 case in upper thoracic segment, 15 cases in median thoracic segment, and 8 cases in inferior thoracic segment. All the cases were pathologically diagnosed as SCC preoperatively. SPVATS was performed to free thoracic esophagus and dissect the lymph nodes, and laparoscopy was performed to free stomach and to perform esophagus-left gastric collum anastomosis. Results RESULTS: All the patients were successfully completed SPVATS, with average thoracic surgery time as 150 min, intraoperative blood loss as 30–260 ml (average 90 ml), and postoperative hospital stay as 9–16d (average 12d). Conclusion CONCLUSIONS: SPVATS was technically feasible and safe in treating TESCC using McKeown approach, with less trauma and rapid postoperative recovery, so it could be used as a new surgical option for McKeown approach-based TESCC treatment. Disclosure All authors have declared no conflicts of interest.