ERAS in Totally Laparoscopic Total Gastrectomy for Gastric Cancer

Inclusion Criteria: 1. 18-80 years; 2. ASA I-III; 3. ECOG ≤2; 4. NRS2002: 0-2; 5. Preoperative gastroscopy and pathological biopsy confirmed adenocarcinoma; 6. The clinical stage of abdominal hypotonic enhanced CT or ultrasonic gastroscopy is cT2-3N0-3M0 or cT1N+M0 or cT4aN0M0 (according to the AJCC-8thTNM tumor staging); 7. Proposed D2 total laparoscopic radical gastrectomy (without limitation on the anastomotic method); 8. All patients did not receive adjuvant radiotherapy, chemotherapy, or other cytotoxic treatments before surgery; 9. Borrmann I-III ; 10. No history of upper abdominal surgery (except for laparoscopic cholecystectomy); no history of peritonitis or pancreatitis 11. hemoglobin ≥80g/L; absolute neutrophil count (ANC) ≥1.5×109/L; platelet ≥100×109/L; ALT, AST≤1 times the upper limit of normal; ALP≤1 times the upper limit of normal; total serum bilirubin \<1.5 times the upper limit of normal; serum creatinine \<1 times the upper limit of normal; serum albumin ≥35g/L; Exclusion Criteria: 1. tumors at the esophagogastric junction or gastric tumors that have invaded the pyloric canal; 2. Those with uncontrolled epilepsy, central nervous system diseases, or a history of mental disorders; 3. Severe (i.e., active) heart disease, such as symptomatic coronary heart disease, New York Heart Association (NYHA) class II or more severe congestive heart failure, or severe drug-dependent arrhythmia, or a history of myocardial infarction within the last 6 months; 4. Patients with urinary dysfunction who require long-term indwelling catheters after surgery; 5. Patients who need immunosuppressive therapy for organ transplantation; 6. Patients with severe uncontrolled recurrent infections or other severe uncontrolled concomitant diseases; 7. Moderate or severe renal impairment \[creatinine clearance equal to or lower than 50ml/min (calculated according to the Cockroft and Gault equation), or serum creatinine \> upper limit of normal (ULN); 8. Emergency surgery due to tumor emergencies (bleeding, perforation, obstruction); 9. Pregnant or breastfeeding women; 10. Previously diagnosed other tumors (excluding cervical cancer and cutaneous melanoma)