Objective To evaluate the effect of mechanical suture in surgery of esophageal carcinoma,Methods Five hundred and sixty-eight cases of esophagogastrostomy and esophagojejunostomy for esophageal and cardiac carcinoma were collected in our hospital between January, 1988 and December, 2002. They were devided into two groups according to the methods of anastomoses, the group by stapler and the group with hand. The incidence of postoperative complications in the two groups was compared. Results The time of esophagogastrostomy, the total operating time, and postoperative fasting time of group by stapler were shorter than those of group with hand (Plt;0. 01), and there was no statistically difference in the median hospitalized time after operation for two groups. The anastomotic leakage, anastomotic stricture, anastomotic bleeding , incidence of postoperative complications in respiration and circulation and mortality rate of group by stapler were lowed than those of group with hand (2.1%, 1.4%,0%,2.8% and 0.7% vs.6.8%,4.3%,1.4%,16.5% and 2.9%). There was no statistical difference in the postoperative gastro-esophageal reflux for two groups (P 〉 0.05 ). Conclusion The median time of esophagogastrostomy and the median operating time by stapler are decreased and the incidence of postoperative complications is decreased.