68 Annals of Cancer Research and Therapy Vol. 29 No. 1, 2021 Ann. Cancer Res. Ther. Vol. 29, No. 1, pp. 68-72, 2021 INTRODUCTION Esophageal cancer is one of the leading causes of can- cer-related death worldwide. Esophageal cancer is cur- rently the seventh most common malignant tumor in men in Vietnam, and the vast majority of esophageal cancers are squamous cell carcinomas 1) . Esophagectomy plays a significant role in the treatment strategy for resectable thoracic esophageal cancer. However, esophagectomy is a highly invasive procedure that can lead to severe post- operative complications 2) . Recently, results from several prominent academic institutions have demonstrated the feasibility of the minimally invasive esophagectomy (MIE) 3-6) . This technique is technically challenging and requires advanced laparoscopic and thoracoscopic skills. With experience gained from open esophagectomy as well as laparoscopic surgery, thoraco-laparoscopic esoph- agectomy was introduced in 2016 in our hospital. We re- port the experience of using MIE at the multidisciplinary public hospital with 3,000 beds in central Vietnam. MATERIALS AND METHODS We conducted a prospective, nonrandomized, obser- vational study in Hue central hospital, which is one of the biggest hospitals in Vietnam, from January 2016 to January 2021. The hospital ethics committee approved the study protocol and all modifications during the study. The written informed consent was obtained from all pa- Outcome for esophageal cancer following thoraco-laparoscopic esophagectomy: A single institution experience Ho Huu Thien, Tran Nghiem Trung, Pham Trung Vy, Phan Hai Thanh, Nguyen Thanh Xuan, Pham Xuan Dong, Mai Trung Hieu, Van Tien Nhan, Pham Nhu Hiep Department of Abdominal Emergency and Paediatric Surgery, Hue Central Hospital, Hue city, Vietnam Abstract Background: The feasibility and the safety of the thoraco-laparoscopic esophagectomy (TLE) was proved by several prominent academic institutions. This technique is technically challenging and requires advanced laparoscopic and thora- coscopic skills. With experience gained from open esophagectomy as well as laparoscopic surgery, thoraco-laparoscopic esophagectomy was introduced in our hospital in 2016. We report our experience in performing TLE. Materials and Methods: We conducted a prospective, nonrandomized, observational study in Hue central hospital, which is one of the biggest hospitals in Vietnam, from January 2016 to January 2021. This study included the esophageal cancers that were diagnosed by endoscopy and confirmed by pathology. Esophageal cancer with cT1b-3N0M0 using chest CT, ultrasound-endoscopy, abdominal CT was indicated for resection initially, while esophageal cancer with cT4N0M0 or T3N(+)M0 was indicated for resection after neoadjuvant therapy. The patients had the ASA I-III. All the data were analyzed statistically using SPSS software (SPSS, Inc, Chicago, IL). Results: We used the TLE technique to operate for 52 consecutive patients. All patients were in a semi-prone position. The male/female ratio was 47/5. The mean age was 57.3±6.3 years, and the mean BMI was 20.5±3.3 kg/m 2 . The preoperative location of the esophageal cancer was the upper one-third in two (3.8%), the middle one-third in 24 (46.1%), and the lower one-third in 26 (50.0%). The majority of our patients had cTNM stage II (30, 57.7%). Only seven patients (13.7%) had cTNM stage I, whereas 15 patients (31.4%) had cTNM stage III. Of the 45 patients (stage II and III) who needed the neoadjuvant therapy, 30 (57.7%) received short-courses, 15 (28.8%) received long-course of chemotherapy. For 24 patients (46.1%), the histopathology was squamous cell carcinoma. The remaining 28 patients (53.8%) had adenocarcinomas. The operative time was 311.2±45.9 minutes. We did not record either conversion or intraoperative events. The mortality and morbidity rates were 1.9% and 23%, respectively. The hospital stay was 15.6±7.2 days. The median follow-up time was 22±1.5 months, and the overall survival rate at one year was 84.7%. Conclusion: Thoraco-laparoscopic esophagectomy for esophageal cancer with the patient in a semi-prone position is safe and effective, including the lower morbidity rate and the shorter operative time while preserving the long-term outcomes. Keywords: Esophageal Neoplasms, Thoracoscopy, Esophagectomy (Received March 19, 2021; Accepted April 21, 2021) Corresponding author : Tran Nghiem Trung, MD., Department of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital. 16 Le Loi Street, Hue City, Vietnam. TEL: +84905046446, E-mail: nghiemtrungbs@yahoo.com