Objective To compare the outcome of tubular stomach and cervical esophagus laminated anastomosis and mechanical anastomosis. Methods A total of 128 patients with middle and upper esophageal cancer in our hospital from January 2013 to January 2016 were randomly divided into two groups, 64 patients in each group and all patients underwent esophagectomy. In the group A, there were 46 males and 18 females with age of 40–75 years, treated with tubular stomach and cervical esophagus layered anastomosis. There were 51 males and 13 females with age of 43–71 years in the group B receiving mechanical anastomosis. We observed the short-term and long-term efficacy as well as complications. Results In the group A, there was cervical anastomotic fistula in 1 patient, anastomotic stenosis in 2 patients and reflux esophagitis in 12 patients. In the group B, 1 patient suffered chylothorax, 8 patients cervical anastomotic fistula, 4 patients anastomotic stenosis and 14 patients reflux esophagitis. Conclusion Layered anastomosis can effectively reduce the incidence of anastomotic fistula and stenosis. Tubular stomach can effectively prevent and reduce the reflux esophagitis, and the high long-term quality of life will be achieved after the operation.