To explore the feasibility and safety of laparoscopic D2 total gastrectomy and complete mesenteric resection (CME) for advanced gastric cancer.

From January 2015 to January 2020, three hundred patients with advanced gastric cancer admitted to the South Hospital of Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University were collected. One hundred and fifty patients underwent standard D2 total gastrectomy (D2 group), and the other 150 patients received CME treatment on the basis of D2 group (D2+CME group). The operation time, blood loss and lymph node dissection were compared between the two groups, and the postoperative recovery indexes such as hospitalization time, postoperative exhaust time, semi-liquid diet time and the bed-off time were recorded. The incidence of postoperative complications, recurrence and mortality of the two groups were compared.

There were no significant differences in operation time, blood loss, hospital stay, postoperative exhaust time, semi-liquid diet time and bed-off time between the two groups. Compared with D2 group, the number of lymph node dissection in D2+CME group was significantly higher, and the rate of incomplete mesenteric resection was significantly lower (P<0.05). The incidence of postoperative complications, recurrence rate and mortality in D2+CME group were significantly lower than those in D2 group (P<0.05).

Laparoscopic D2 total gastrectomy combined with CME has a good therapeutic effect on advanced gastric cancer, and the prognosis of patients is good. As a safe and effective operation, it is worthy of clinical application.