Objective To investigate the safety and efficacy of mechanical anastomosis with Chinese staplers in the surgical treatment of esophageal carcinoma and carcinoma of gastric cardia in order to find out an altative effective anastomotic technique to hand-sewn method. Results Compared with the reported postoperative leakage rate from 2%-4% in China and 4.2%-12.3% abroad, our techniques reduced the total leakage rate to 0.8%, that is, cervical leakage rate was 11.4% (5/44), and intrathoracic leakage rate 0.57% (11/1921). The intrathoracic leakage rate was 0.99% (8/808) for the first 8 years, and 0.27% for the following 8 years. There was no leakage (0/350) in the last 3 years. The anastomotic stricture occurred in 98 patients (4.99%) which could be relieved by Bougie or balloon dilatation. The total operative mortality was reduced to 0.76%.Conclusions Mechanical anastomosis with Chinese staplers combined with telescope suturing should be an effective method to prevent the occurrence of anastomotic leakage after esophageal resections.