Esophageal cancer resection using gastric substitution is considered to be the current standard procedure for radical or palliative surgery. Esophagogastric anastomoses can be performed using hand sutures or mechanical sutures in the neck or chest. Survival rates for patients surgically treated for esophageal cancer are known to have improved in recent years, in part due to improvements in surgical technique and perioperative treatment. The prognosis of patients is closely related to the occurrence of early complications of the esophagogastric anastomosis, such as anastomotic leak, which can lead to serious complications or even death. In addition, anastomotic stricture, one of the major surgical complications, can lead to dysphagia. The effect of using an anastomosis or hand sutures in performing esophagogastric anastomosis on postoperative complications, mortality and quality of life remains controversial. In order to compare the clinical outcomes between manual suturing and the anastomosis technique for esophageal cancer with esophagectomy-esophagogastric anastomosis, Professor Min Jiaxin of the Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, conducted a prospective randomized controlled study, which was recently published in the European Journal of Cardio-Thoracic Surgery. The study was a prospective randomized controlled trial of 477 patients with esophageal cancer from February 2009 to December 2011. 237 patients were randomly assigned to the manual suture group and 241 patients were assigned to the loop anastomosis group. The mean follow-up period was 18 months. The mean operative times were 193 and 226 minutes for the clutch and manual suture groups, respectively. Clinical and radiographic anastomotic leakage occurred in 17 and 7 cases in the hand-sutured and anastomotic groups, respectively. In-hospital deaths occurred in 10 cases (4.3%) in the anastomosis group and 16 cases (14.2%) in the manual suture group. Anastomotic stenosis occurred in 31 cases (14.2%) in the anastomosis group compared with 16 cases (7.5%) in the manual suture group. These results found that although the circumferential anastomosis increased the incidence of benign esophageal strictures after esophagectomy-esophagogastric anastomosis for esophageal cancer, it significantly reduced operative time and the incidence of anastomotic leak; and some other surgical outcomes were similar between the two groups. Because of the lower complication and anastomotic leak rates and less operator dependence, the use of the anastomosis clutch is a better choice for esophageal cancer with esophagectomy-esophagogastric anastomosis.