Background  Laparoscopic surgery has been widely used, but some scholars still hold a wait-and-see attitude to the complete laparoscopic technique.

  Objective  To compare the perioperative efficacy of complete laparoscopy versus laparoscopic-assisted surgery combined total gastrectomy and Roux-en-Y esophagojejunal anastomosis.

  Methods  A retrospective analysis was performed on the clinical data about 155 cases of gastric cancer treated by radical gastrectomy and Roux-EN-Y anastomosis in the First Medical Center of Chinese PLA General Hospital from January 2018 to December 2020. There were 86 males and 69 females with age range of 52-72 years, 87 cases underwent complete laparoscopic surgery (T group) and 68 cases underwent laparoscopic assisted surgery (L group). The operative time, intraoperative blood loss, surgical incision length, postoperative gastric tube extraction time, postoperative exhaust time, total length of stay, incidence of anastomotic fistula, incidence of anastomotic bleeding, incidence of duodenal stump fistula, postoperative pathological report of resection margin positive rate and lymph node detection number and positive rate were compared between the two groups.

  Results  There were no statistically significant differences in age, gender, BMI, TNM stage and other clinical baseline data between the two groups (all P＞0.05). Compared with the laparoscopic assisted surgery group, the intraoperative blood loss (58.20±38.80 mL vs 98.13±47.87 mL, P＜0.05), incision length (4.03±1.03 cm vs 10.99±1.01 cm, P＜0.05), postoperative gastric tube removal time (13.43±1.57 h vs 63.01±21.29 h, P＜0.05), postoperative exhaust time (40.08±19.98 h vs 64.58±28.08 h, P＜0.05), total length of hospital stay (7.55±1.55 d vs 8.97±2.03 d, P＜0.05) were better in the complete 3D laparoscopic surgery group. There were no statistical differences between the two groups in terms of operation time, positive lymph node detection rate and postoperative complications (P＞0.05).

  Conclusion  Complete 3D laparoscopic radical gastrectomy and Roux-en-Y anastomosis of esophagus and jejunum can achieve better clinical results, and it has the characteristics of small surgical trauma and quick recovery.