Side-overlap esophagogastrostomy offers significant benefits over circular stapled techniques for Siewert type I/II adenocarcinoma.

• Postoperative pain scores on day 1 and 2 were significantly lower in the side-overlap group (3.49 vs. 4.04 and 2.73 vs. 3.06, respectively).
• Severe gastroesophageal reflux occurred in just 14.5% of the side-overlap group versus 34.0% with circular stapling.
• Dysphagia symptoms were less frequent in the side-overlap group (9.1% vs. 24.0%).

Consider side-overlap anastomosis to enhance postoperative recovery and reduce complications in these patients.