In the past 20 years, domestic and foreign thoracic and laparoscopic surgery has been widely carried out, and the technology has become more and more mature, with a large accumulation of relevant experience and expanding and standardized surgical indications, and has developed into one of the standard new techniques of minimally invasive thoracic surgery. Especially after 2000, with the popularization and application of thoracoscopic lobectomy in the United States, Japan and other developed countries, more and more doctors and patients hope to apply thoracoscopic and laparoscopic treatment for esophageal cancer in order to reduce the complications caused by large trauma. Although the technology of combined thoracoscopic and laparoscopic radical esophageal cancer surgery has been relatively mature in several foreign hospitals. Combined thoracic and laparoscopic radical treatment of esophageal cancer has enabled our thoracic surgery department to break through the stagnant situation in esophageal cancer surgery in recent years, and to truly approach the international advanced ranks in esophageal cancer surgery, which is of great significance to improve thoracoscopic surgery technology. Anesthesia Conventional double-lumen tracheal intubation with general anesthesia. Intraoperative single-lung ventilation was performed to ensure that the lung was sufficiently atrophied to present sufficient space for surgical operation. During intraoperative placement of the staple@, the anesthesiologist’s cooperation is required to loosen a small amount of the tracheal intubation balloon. Surgical approach 1. Laparoscopic freeing of the stomach This is a tedious operation in which 5 trocar are placed in the abdomen, firstly along the lesser curvature of the stomach to the esophageal diaphragmatic foramen and the diaphragmatic angle; then, along the greater curvature of the stomach to the esophageal diaphragmatic foramen and the diaphragmatic angle. The short gastric vessels were cut with ultrasonic knife; after that, the left gastric vessels were cut by returning to the lesser curvature of the stomach, and the gastric tube was plasticized along the lesser curvature of the stomach. 2. When performing thoracoscopy, it is the same as traditional open thoracotomy, and the operator performs the operation through a small incision in the anterior chest wall + under the thoracoscopic surveillance screen. The thoracic lens is inserted into the trocar for routine intrathoracic exploration to understand the thoracic cavity, pulmonary fissure, hilum and lesion site, so that the appropriate surgical approach can be taken. The thoracoscopic cold light source lamp (through the trocar or small incision) is used for endoscopy or illumination, and the operator performs a combination of operations through the monitor screen to separate adhesions and dissect the pulmonary fissures, hilum, pulmonary vessels and trachea with minimally invasive instruments. For lung cancer, all groups of lymph nodes need to be cleared. The use of disposable instruments during surgery can significantly shorten the operation time, reduce trauma, simplify the operation and reduce the incidence of complications. Postoperative treatment and observation The tracheal intubation was removed as soon as possible after surgery and sent to ICU for monitoring. Fasting for 7 days, rehydration support and antibiotics for 2-3 days. Chest radiographs were reviewed 1 day after surgery for lung expansion, and at intervals of 3 months thereafter as appropriate. We have completed 35 cases of combined thoracic and laparoscopic radical esophageal cancer surgery, and the operation time was shortened from more than 9-10 hours initially to about 4 hours. Quick recovery of patients after surgery is one aspect, and the main thing is that after a period of recovery, patients can maintain near normal working life ability.