Patient case (clinical description): A 63-year-old man comes to the clinic for recent unintentional weight loss. The patient also has epigastric discomfort after meals. He has no known medical problems and takes no medications. His blood pressure is 130/75 and pulse rate is 88/min. He is not febrile. Upper endoscopy shows a lesion in the stomach that shows typical features of diffuse-type adenocarcinoma presenting with signet ring cells that do not form glands.

Patient's own account: I went to the clinic because I had been losing so much weight that it was concerning. I'm a 63-year-old guy, and it is something rather unusual. I'm always suffering from stomachache after every meal. I've never been sick, and I don't take any medicine. The doctor took my blood pressure and told me it was 130/75, and my pulse rate was 88/min. I'm not febrile! I also had to do an endoscopy, and they found a lesion in my stomach that shows typical features of stomach cancer. I'm totally devastated...

Clinical trial: The Safety of Totally Laparoscopic Versus Laparoscopy-Assisted Total Gastrectomy.

Eligibility criteria:
Inclusion Criteria:

          1. Aged 18-75 years；

          2. Primary lesion is diagnosed with endometrial biopsy as adenocarcinoma of the stomach
             or esophagogastric junction, including: papillary adenocarcinoma, tubular
             adenocarcinoma, mucinous adenocarcinoma, poorly cohesive carcinoma (including signet
             ring cell carcinoma and other variants), mixed adenocarcinoma, etc.；

          3. Clinical stage cT1N0M0, cT1N1M0, cT2N0M0；

          4. The gastric primary lesion is located in the body or fundus of stomach or the
             esophagogastric junction. It is expected that total gastrectomy with D1+/D2 lymph node
             dissection achieves R0 resection (multiple primary cancers are also applicable)；

          5. BMI(Body Mass Index)<30 kg/m2；

          6. No history of upper abdominal surgery (except for laparoscopic cholecystectomy)；

          7. No prior treatment of chemotherapy, radiotherapy, targeted therapy, immunotherapy,
             etc.；

          8. Preoperative ECOG (Eastern Cooperative Oncology Group) performance status score 0 or
             1；

          9. Preoperative ASA (American Society of Anesthesiologists) scoring I-III；

         10. Sufficient vital organ functions；

         11. Signed informed consent.

        Exclusion Criteria:

          1. Preoperative examination indicates disease stage cStage II or above；

          2. Women during pregnancy or lactation；

          3. Suffer from other malignant tumors within 5 years；

          4. Preoperative body temperature ≥ 38°C or complicated with infectious diseases requiring
             systemic treatment；

          5. Severe mental illness；

          6. Severe respiratory disease；

          7. Severe liver and kidney dysfunction；

          8. History of unstable angina or myocardial infarction within 6 months；

          9. History of cerebral infarction or cerebral hemorrhage within 6 months；

         10. Continuous application of glucocorticoid within 1 month (except for topical
             application)；

         11. Accompanied by gastric cancer complications (bleeding, perforation, obstruction, etc.)
             ；

         12. The patient has participated in or is participating in other clinical studies (within
             6 months).
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 75 Years

Eligibility (NLI label): Entailment