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AIM: To reduce the incidence of postoperative anastomoticleak, stenosis, gastroesophageal reflux (GER) for patientswith esophageal carcinoma, and to evaluate the conventionalmethod of esophagectomy and esophagogastroplastymodified by a new three-layer-funnel-shaped (TLF)esophagogastric anastomotic suturing technique.METHODS: From January 1997 to October 1999, patientswith clinical stage Ⅰ and Ⅱ (Ⅱa and Ⅱb) esophagealcarcinoma, which met the enrollment criteria, were surgicallytreated by the new method (Group A) and by conventionaloperation (Group B). All the patients were followed at leastfor 6 months. Postoperative outcomes and complicationswere recorded and compared with the conventional methodin the same hospitals and with that reported previously byMcLarty etalin 1997 (Group C).RESULTS: 58 cases with stage Ⅰ and Ⅱ (Ⅱa and Ⅱb)esophageal carcinoma, including 38 males and 20 femalesaged from 34 to 78 (mean age: 57), were surgically treatedby the TLF anastomosis and 64 by conventional method inour hospitals from January 1997 to October 1999. The qualityof swallowing was improved significantly (Wilcoxon W＝2 142,P＝0.0 001) 2 to 3 months after the new operation in GroupA. Only one patient had a blind anastomatic fistula diagnosedby barium swallow test 2 months but healed up 3 weekslater. Postoperative complications occurred in 25 (43 %)patients, anastomotic stenosis in 8 (14 %), and GER in 13(22 %). The incidences of postoperative anastomotic leak,stenosis and GER were significantly decreased by the TLFanastomosis method compared with that of conventionalmethods (x2＝6.566, P ＝0.038; x2＝10.214, P＝ 0.006;x2＝21.265, P＝0.000).CONCLUSION: The new three-layer-funnel-shapedesophagogastric anastomosis (TLFEGA) hasmore advantagesto reduce postoperative complications of anastomotic leak,stricture and GER.