Laparoscopic esophagostomy (LE) and open esophagostomy (OE) are two surgical approaches used to create an esophageal opening for enteral nutrition and medication administration. This abstract presents a comprehensive comparison of LE and OE, focusing on efficacy, safety, postoperative complications, and patient satisfaction. Both techniques have shown efficacy in providing adequate nutrition and medication support. LE offers advantages in terms of precise dissection and securement of the feeding tube or catheter due to magnified visualization and improved access to the esophagus. OE allows for direct access to the esophagus, enabling accurate placement of the esophagostomy opening and tactile feedback to the surgeon. In terms of safety, LE is associated with a minimally invasive approach, resulting in reduced tissue trauma, decreased blood loss, lower rates of wound infections, and shorter hospital stays compared to OE. However, OE can still be performed safely and effectively by experienced surgeons. Postoperative complications, including wound infections, respiratory complications, and incisional hernias, have been reported to occur less frequently in LE compared to OE. Patient satisfaction is generally higher with LE due to reduced postoperative pain, faster recovery, and improved cosmetic outcomes. However, OE can still yield satisfactory results. The choice between LE and OE should be based on individual patient factors, surgeon expertise, and the complexity of the case. Further research is needed to optimize outcomes and refine the comparison between the two techniques.