[Progress in the treatment of early gastric cancer with Laparoscopic and endoscopic cooperative surgery].

With the introduction of minimally invasive methods into the field of surgery, the concept of early gastric cancer (EGC) treating has gradually changed from the pursuit of standardized traditional surgical methods to precise, individualized, interdisciplinary collaborative management. Both endoscopic therapy and laparoscopic surgery have their limitations for early gastric cancer treatment. Meanwhile, Laparoscopic and endoscopic cooperative surgery (LECS) combines the advantages of endoscopy and laparoscopy to perform local gastric resection and regional lymph node dissection, providing a more effective surgical approach for radical resection of early gastric cancer. The application of LECS in the treatment of early gastric cancer has been increasing, from the initial laparoscopy-assisted endoscopic full-thickness resection to the evolvement of a variety of improved procedures such as combined laparoscopic and endoscopic approach for neoplasia with a non-exposure technique, non-exposed endoscopic wall-inversion surgery, and the possibility of combined (sentinel lymph node drainage area) regional lymph node dissection or sentinel lymph node navigation surgery, which expands the indications for endoscopic surgery and maximizes the preservation of normal gastric tissue structure and function while ensuring radical treatment, and will certainly become an important development direction in the treatment of early gastric cancer in the future.随着微创技术的发展，早期胃癌的治疗理念逐渐由追求标准化的传统手术方式转变为精准化、个体化和交叉学科间的合作诊疗。内镜下切除和腹腔镜手术是目前早期胃癌治疗的主流手段，但两者均存在一定局限性。腹腔镜与内镜联合手术（LECS）则结合内镜和腹腔镜优点，进行胃局部切除和区域淋巴结清扫，为早期胃癌的根治性切除提供了一种更为有效的手术方式。LECS在早期胃癌治疗方面的应用不断增多，从最初的腹腔镜辅助内镜下全层切除术，逐步衍生出非暴露技术腹腔镜-内镜联合入路肿瘤切除术、非暴露内镜下胃壁翻转术等多种改良术式，并可联合（前哨淋巴结引流区）区域淋巴结清扫或前哨淋巴结导航手术，扩大了内镜手术适应证，在确保根治的前提下，最大限度保留了正常胃的组织结构和功能，必将成为未来早期胃癌治疗中的重要发展方向。.