To explore the effect and clinical significance of en bloc esophagectomy through thoracoscopy-laparoscopy based on the membrane anatomy.

148 patients who underwent en bloc esophagectomy through thoracoscopy combined with laparoscopy were retrospectively enrolled and divided into two groups, including 69 in the membrane anatomy (MA) group and 79 in the control group. The clinical data, surgical technique, complications and recurrence in short term were analyzed.

Surgical treatment was successfully conducted in all patients. Compared to control group, the MA group showed less operation time [(214.3±34.8) min vs (294.8±56.7) min, P<0.001], less intraoperative blood loss [(54.9±23.4) ml vs (108.4±32.4) ml, P<0.05], more dissected lymph nodes [(26.8±5.8) vs (23.4±7.3), P<0.05] and low rate of complication [5.8%(4/69) vs 17.7%(14/79), P=0.027]. Postoperative hospital stay, first liquid feeding time and thoracic drainage tube removing time had no significance (P>0.05). During the follow-up [(16.0±3.1) months in MA group versus (14.1±1.7) months in control group], there was no significance in metastasis (P>0.05).

Based on the membrane anatomy theory, the en bloc radical esophagectomy through thoracoscopy combined with laparoscopy is safe, with shorter operation time, lower rate of metastasis, more lymph nodes dissection and decreased blood loss.