Objective To explore the feasibility and perioperative prognosis of quadrilateral endoscope through neck combined with laparoscopy for the treatment of esophageal cancer.

Methods Clinical data of 20 patients who received quadrilateral endoscope combined with laparoscopic radical resection of esophageal cancer in Department of Thoracic Surgery, Zhongshan Hospital, Fudan University from July 2022 to March 2023 were retrospectively analyzed. There were 17 males and 3 females, with an average age of (69±8.6) years old. 1 case of tumor located in the upper thoracic segment, 8 cases in the middle thoracic segment, 9 cases in the lower thoracic segment, and 2 cases in the esophageal gastric junction. 18 cases were squamous cell carcinoma and 2 cases were adenocarcinoma. Preoperative staging included 13 cases in stage Ⅰ, 6 cases in stage Ⅱ, and 1 case in stage Ⅲ.

Results All patients underwent surgery successfully without transitioning to transthoracic surgery. The average surgical time was (172.1±26.4) min, the average intraoperative bleeding was (80±36.7) mL, the average number of lymph node dissection was 12.5±6.4, the average hospital stay time was (14.6±12.1) d, the removal time of abdominal drainage tubes was (3.8±1.4) d, and the removal time of gastric tubes was (8.6±9.5) d. The removal time of the neck drainage tube was (9.7±5.1) d, and 4 cases were discharged with the neck drainage tube preserved. The tube was removed 2 weeks later. Three cases underwent intraoperative reinforcement of the anastomosis and retention of the contralateral neck drainage tube. The removal time of the contralateral drainage tube was (5.0±0.8) d. After surgery, 2 cases of anastomotic leakage, 5 cases of left pleural effusion, and 4 cases of bilateral pleural effusion were observed. There were no recurrent laryngeal nerve injury, chylous leakage, or pulmonary complications.

Conclusions The combination of quadrilateral endoscope with laparoscopic radical esophagectomy is a safe and feasible minimally invasive surgical method, which has potential advantages such as minimal trauma, short surgical time, low intraoperative blood loss, and fast postoperative recovery. It is expected to be further promoted.