To investigate the efficacy and safety of laparoscopic D₂ radical gastrectomy with complete mesorectal excision (CME) under the guidance of mesenteric anatomy theory in advanced gastric cancer.

A total of 92 patients with advanced gastric cancer treated in Qionghai Traditional Chinese Medicine Hospital from March 2019 to May 2021 were prospectively selected and divided into study group and control group by numerical random method, with 46 cases in each group. The study group was treated with laparoscopic D₂ radical resection plus CME based on the theory of mesenteric anatomy, while the control group was treated with standard laparoscopic D₂ radical gastrectomy. The perioperative indicators and postoperative complications of the two groups were observed. Kaplan-Meier curve was used to analyze the prognosis and survival.

Both groups successfully completed the operation without conversion to laparotomy. The operation time, intraoperative blood loss, time of first exhaust/defecation and hospitalization in the study group were shorter than those in the control group, and the number of cleared lymph nodes and detected positive lymph nodes in the study group were more than those in the control group (all P<0.05). There was no significant difference in the total incidence of complications between the two groups (χ²=3.023, P=0.082). The recurrence rate and 3-year cumulative total survival rate in the study group were better than those in the control group (χ²=4.564、3.861; P=0.033, 0.046).

Laparoscopic D₂ radical gastrectomy plus CME for advanced gastric cancer based on the theory of mesenteric anatomy is safe and feasible, with shorter operation time, less blood loss and more thorough lymph node dissection, which can effectively promote postoperative recovery, reduce tumor recurrence and improve the survival rate.