Intrathoracic side-overlap esophagogastrostomy (SOE) shows promise as a viable alternative to circular stapled (CSE) technique in esophagectomy for Siewert type I/II adenocarcinoma.

• SOE leads to significantly lower postoperative pain scores: 3.49 vs. 4.04 on day one (p=0.002).
• Severe gastroesophageal reflux is lower with SOE (14.5%) compared to CSE (34.0%) (p=0.019).
• Dysphagia symptoms are reduced with SOE (9.1% vs. 24.0% in CSE, p=0.038).

Surgeons may consider shifting to SOE for better short-term outcomes in selected patients.