Objective: To explore the application effect of double fixed laparoscopic jejunostomy in total endoscopic Ivor-Lewis operation for esophageal cancer. Methods: A retrospective analysis was conducted on 106 patients who underwent totally laparoscopic Ivor-Lewis esophagectomy performed by the same surgical team. Patients were divided into an observation group and a control group based on the jejunostomy technique used, with 53 cases in each group. The control group underwent traditional sutured laparoscopic jejunostomy, while the observation group underwent double-fixation laparoscopic jejunostomy. The postoperative jejunostomy tube removal time and time to first flatus were compared between the two groups. The inflammatory stress indicators [norepinephrine (NE), cortisol (COR), C-reactive protein (CRP)] before and 4 weeks after surgery were detected and compared. The levels of nutritional markers [serum albumin (ALB), globulin (GLB), hemoglobin (Hb)] were measured and compared before, 4 and 12 weeks after operation. The incidence of complications was also recorded for each group. Results: The observation group had shorter times to stoma tube removal and first anal exhaust compared to the control group (P0.05). Conclusion: Double-fixed laparoscopic jejunostomy combined with Ivor-Lewis operation can effectively reduce the incidence of postoperative intestinal obstruction, relieve inflammatory stress, and improve the nutritional status of patients, which is worth popularizing.