[The technique of laparoscopic-thoracoscopic esophageal resection for esophageal cancer--first experiences]

Esophageal resection for carcinoma is still associated with high mortality and morbidity. Minimally invasive techniques are regarded to reduce operative trauma. However, to date only few studies on minimally invasive esophageal resection have been published. We describe in detail the technique of combined laparoscopic and thoracoscopic esophageal resection with gastric-pull-up and conventional open cervical anastomosis for esophageal squamous carcinoma. Prone positioning of the patient with bilateral lung ventilation was used during the thoracoscopic part of the operation. Our first experiences in 5 patients confirm the feasibility of the technique. We did not observe any surgical related adverse incidences and found the typically advantages of minimally invasive surgery, such as early mobility, less pain and a comfortable cosmetic result in our patients. Although the number of procedures is to low to decide the value of minimally invasive surgery for esophageal cancer, we think it could be a promising technology to reduce mortality and morbidity for esophageal resection.