ObjectiveTo investigate the safety and efficacy of naked eye 3D thoracoscopic surgery in minimally invasive esophagectomy.MethodsClinical data of 65 patients, including 50 males and 15 females aged 47-72 years, with esophageal cancer who underwent minimally invasive thoracoscopic esophagectomy from October 2018 to April 2019 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods including a naked eye 3D thoracoscopic group (group A: 30 patients) and a traditional 2D thoracoscopic group (group B: 35 patients). The effects of the two groups were compared.ResultsThe operation time in the group A was significantly shorter than that in the group B (P<0.05). The number of dissected lymph nodes in the group A was more than that in the group B (P<0.05). The thoracic drainage volumes on the 1th-3th days after operation in the group A were significantly larger than those in the group B (P<0.05), but there was no significant difference between the two groups on the 4th-5th days after operation (P>0.05). The indwelling time in the group A was longer than that in the group B (P<0.05). Postoperative hospital stay, pulmonary infection, arrhythmia, anastomotic leakage, and recurrent laryngeal nerve injury were not significantly different between the two groups (P>0.05).ConclusionNaked eye 3D thoracoscopic surgery for minimally invasive esophagectomy is a safe and effective surgical procedure. Compared with traditional 2D minimally invasive thoracoscopic surgery, it is safer in operation and more thorough in clearing lymph nodes. The operation is more efficient and can be promoted.