Choosing between tubular esophagogastric and double-tract anastomosis for older patients can affect perioperative safety and long-term quality of life.

• Patients aged 70+ had fewer complications with tubular esophagogastric (25.9% vs. 50.0% for double-tract, p=0.049).
• Double-tract anastomosis had longer operative times (232.1 min vs. 217.6 min for tubular esophagogastric, p=0.016) and better reflux control at 12 and 24 months (p<0.05).

Consider age when selecting the anastomosis type to balance risks and functional outcomes.

• Double-tract showed lower anastomotic stenosis rates at 3 months (4.0% vs. 11.4%, p=0.038).