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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/m2. 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. © 2021, PJD Publications Ltd. All rights reserved.

Background: Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is gaining popularity as a treatment for choledochal cyst in children. The aim of this study is to determine the feasible and safe of the laparoscopic excision with Roux-en-Y hepaticojejunostomy, and evaluate the short-term outcomes after treatment for children with choledochal cyst.Methods: A prospectively of 51 consecutive pediatric patients undergoing laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy performed by one surgeon cysts at Hue Central Hospital from June 2012 to December 2017 was studied.Results: The mean operative time was 214.7±67.95 minutes (range, 100~360 minutes), including the time for intraoperative cholangiography. There were two children requiring blood transfusion. Time to first flatus was 40.35±28.55 hours in average. The mean time to drain removal was 2.89±1.02 days. Mean postoperative hospital stay was 9.31±3.43 days. 6 out of 51 cases having early complications, including 2 cases of pancreatitis and 4 cases of bile leakage. Most of cases (90.5%) were classified as good after 10 days to 3 months of follow-up.Conclusions: Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was feasible and safe in children. The short-term outcomes were good in most cases.