摘要Objective:As laparoscopic surgery is widely applied for primarily treated gastric cancer(GC)/gastroesophageal junction cancer(GEJC)and gains many advantages,the feasibility of laparoscopic total gastrectomy(LTG)for GC/GEJC patients who have received preoperative therapy(PT)has come to the fore.This study aims to analyze the safety and feasibility of LTG after PT for GC/GEJC patients.Methods:We retrospectively analyzed the data of 511 patients with GC/GEJC undergoing LTG,of which 405 received LTG(LTG group)and 106 received PT+LTG(PT-LTG group)at Nanfang Hospital between June 2018 and September 2022.The surgical outcomes were compared between the two groups.Results:The surgical duration was significantly longer in the PT-LTG group(P＜0.001),while the incidence of intraoperative complications(P=1.000),postoperative complications(LTG group vs.PT-LTG group:26.2％vs.23.6％,P=0.587),the classification of complication severity(P=0.271),and postoperative recovery was similar between two groups.Notably,the incidence of anastomotic complications of esophagojejunostomy was also comparable between the two groups(LTG group vs.PT-LTG group:5.9％vs.5.7％,P=0.918).The univariate and multivariate analysis confirmed that positive proximal margin[positive vs.negative:odds ratio(OR)=14.094,95％confidence interval(95％CI):2.63 9-75.260,P=0.002],rather than PT,has an impact on anastomotic complications after LTG(OR=0.945,95％CI:0.371-2.408,P=0.905).Conclusions:PT did not increase the surgical risk of LTG for GC/GEJC.Therefore,considering the positive effect of PT on long-term survival,the broader application of PT and LTG for GC/GEJC is supported by our findings.