Expert consensus on multidisciplinary management of laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery for early gastric cancer (2026 edition).

Abstract

With the advancement of surgical techniques and enhanced management of early gastric cancer (EGC), minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians. Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery (LECS-SNNS) has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation. However, robust evidence-based support for guiding clinical implementation remains limited. To address this gap, we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations. These included preoperative assessment, surgical techniques, intraoperative endoscopic procedures, pathological evaluation, postoperative care, and follow-up. This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS, thereby advancing precise, minimally invasive, and function-preserving treatment for EGC.