Endoscopic and surgical interventions significantly enhance outcomes for anastomotic leakage post-esophagectomy.

• Observation group had a 73% fistula closure rate versus 53% in the control group.
• Clinical treatment scores were higher at 3 months (5.67 vs. 4.73) and 6 months (8.33 vs. 6.27) for the observation group.

These findings support early intervention to improve patient quality of life without increasing complication rates.

• Dysphagia scores improved significantly in the observation group, highlighting benefits beyond physical healing.