A novel Y-shaped layered antireflux anastomosis significantly improves outcomes in esophagectomy compared to traditional circular-stapled techniques.

• The Y-shaped group showed lower rates of anastomotic leakage (1.0% vs 5.9%), stricture (3.9% vs 12.3%), dysphagia (4.9% vs 16.8%), and symptomatic reflux (8.8% vs 23.1%).
• Postoperative hospital stays were shorter for the Y-shaped group (11.8 vs 13.2 days, p = 0.003), indicating potential efficiency benefits.

These results support further prospective validation of the Y-shaped technique as a promising option to reduce postoperative morbidity in esophageal surgery.