Objective  To explore the clinical experience of thoracoscopic and laparoscopic esophagectomy for esophageal carcinoma.   Methods  From November 2008 to September 2009

40 cases of esophageal carcinoma were performed in our department by this way. Forty patients were 30 males and 10 females

and aged from 52 to 78 (average 65). There were 2 cases of carcinoma of the upper esophagus

32 cases of carcinoma of the middle esophagus

and 6 cases of carcinoma of the next segment. The pathological types were 39 cases of squamous cell carcinoma and 1 case of adenocarcinoma. Video-assisted thoracoscopic surgical approach was used to free the esophagus and lymph node dissection

and laparoscopic surgical approach was to free the stomach

through the retrosternal tunnel raised to the neck line of esophagogastric anastomosis.   Results  Among the 40 cases

because of 3 cases of pleural adhesion and 1 case of clearly outside the tumor invasion

we had to converse to transit-assisted small incision in the chest. All operative time was 240 to 320 min

with an average of 270 min

thoracoscopic time 45 to 90 min with an average of 60 min

and laparoscopic time 45 to 90 min with an average of 60 min. Intraoperative blood loss was 150 to 300 ml with an average of 200 ml. There were 8 to 20 pieces of lymph nodes removed

with an average of 11.8. All patients were hospitalized from 10 to 13 d

with an average of 11 d. There was no bleeding during operation. Postoperative complications included anastomotic fistula of 6 cases in the neck after the first 8 to 14 d

which were healed after dressing. No postoperative chylothorax

lung infection or respiratory insufficiency was found.   Conclusion  With this thoracoscopic and laparoscopic esophagectomy

we minimize the trauma and complications after operation. This approach has no significant difference with other surgical methods in tumor resection and lymph node dissection

and is simple and easy to perform.