Abstract: Objective To investigate the application effect of the reverse puncture technique in the minimally invasive resection of subesophageal carcinoma by tubular intrathoracic gastroesophageal anastomosis. Methods A total of 22 patients with subesophageal carcinoma were selected and treated with thoracoscopic resection of subesophageal carcinoma. The common polygonal tube stapler and reverse puncture technique were used to reconstruct digestive tract based on tubular intrathoracic gastroesophageal anastomosis. Results In this research, the operation time was(232.40±42.30)min, intra-operative bleeding volume was(348.10±88.20)mL, anastomotic time was(38.40±5.50)min, hospitalization time was(13.70±2.20)d, and postoperative complications rate was 9.09%. Conclusion Application of the reverse puncture technique is effective in the minimally invasive resection of subesophageal carcinoma by tubular intrathoracic gastroesophageal anastomosis.