Laparoscopic-assisted Distal Gastrectomy and Totally Laparoscopic Distal Gastrectomy for Gastric Cancer

Inclusion Criteria: 1. Aged 20-80 years; 2. Patients had an Eastern Cooperative Oncology Group performance status score of 0 or 1; 3. Patients had histologically confirmed gastric adenocarcinoma (tumor size\<5cm) at clinical stage I-III with T1-4aN0-2M0 excluding T4b or N3 tumors, according to the of the American Joint Committee on Cancer classification system, eighth edition; 4. Patients were expected to undergo laparoscopic distal gastrectomy with D2 lymphadenectomy. Exclusion Criteria: 1. Patients had bulky regional lymph nodes (larger than 3 cm at the long diameter) or possible distant metastasis in preoperative evaluation 2. Patients had history of chemotherapy, radiotherapy, immunotherapy or target therapy; 3. Patients had any concurrent or previous malignant tumor; 4. Patients had unstable cardiovascular, respiratory, kidney, or liver disease and poorly controlled hypertension, diabetes, mental disorders; history of upper abdominal surgery (except laparoscopic cholecystectomy). 5. Patients were histologically proven gastric adenocarcinoma (by preoperative gastrofiberscopy).