Objective  To explore the clinical effect of total laparoscopic radical gastrectomy by extracapsular reticular approach in the treatment of patients with advanced gastric cancer.

  Methods  A total of 90 patients with advanced gastric cancer were divided into two groups according to therapeutic method, with 45 cases in each group. Control group was treated with radical gastrectomy, while observation group was treated with total laparoscopic radical gastrectomy by extracapsular reticular approach. The length of incision, operation time, intra-operative blood loss, time to get out of bed after operation, hospitalization time, hospitalization cost, incidence rate of complications and recurrence rate were compared between two groups. The survival rate of the two groups was compared after one year of follow up.

  Results  There was no significant difference in operation time between the two groups (P>0.05). The length of incision, intra-operative blood loss, time to get out of bed after operation and hospitalization time in the observation group were significantly better than those in the control group, and the hospitalization cost was significantly higher than that in the control group (P < 0.05). The incidence rate of complications in the observation group was 4.44%, which was significantly lower than 17.78% in the control group (P < 0.05). There was no recurrence case in the observation group at 6 months after operation, but the recurrence rate of the control group was 4.44%, and there was no significant difference between the two groups (P>0.05). The survival rate of the observation group was 95.35% (41/43), which showed no significant difference when compared to 97.78% of the control group (44/45) (P>0.05).

  Conclusion  Total laparoscopic radical gastrectomyby extracapsular reticular approach is safe and reliable in treating patients with advanced gastric cancer, which can shorten the length of incision, reduce intra-operative blood loss and promote the recovery of patients.