我国胃癌腹腔镜手术历经30年的蓬勃发展、不断创新，已取得了令人瞩目的成绩，然而各地区发展的不平衡仍然是目前面临的挑战。对于早期胃癌而言，腹腔镜手术的总体并发症发生率及死亡率与开腹手术相当，主要并发症包括术中出血、吻合口漏、狭窄、术后排空障碍等。临床数据显示，腹腔镜手术在减少出血、全身炎症反应，加速康复方面具有优势。国内多中心的研究数据表明，对于局部进展期胃癌，新辅助治疗特别是化疗联合免疫治疗（NAIC），能提高病理完全缓解（pCR）率和R0切除率，且未增加术后并发症风险。通过推广腹腔镜胃癌手术的规范化和模块化，引导术者重视系膜解剖相关理念并正确合理使用能量设备，可以缩短学习曲线、降低手术并发症发生率，从而进一步提高我国腹腔镜下胃癌根治术的整体水平。

This article provides an overview of the complications and related management of laparoscopic radical gastrectomy in China, drawing from both literature and current domestic clinical research progress. Laparoscopic radical gastrectomy in China has undergone vigorous development and continuous innovation over the past 30 years, achieving remarkable results. However, the uneven development across regions remains a current challenge. The overall complication rate and mortality rate of laparoscopic radical gastrectomy for early-staging gastric cancer in China are comparable to those of open surgery. The main complications include intraoperative bleeding, anastomotic leakage, stenosis, postoperative emptying disorders, and so on. Data show that laparoscopic surgery has advantages in reducing some systemic complications. Current research indicates that neoadjuvant therapy, especially chemotherapy combined with immunotherapy (NAIC), can improve the pathological complete response rate (pCR) and radical resection rate (R0) without increasing the risk of postoperative complications. The author believes that continuously promoting the standardization and modularization of laparoscopic radical gastrectomy, emphasizing the concept of mesenteric anatomy, and correctly and reasonably using energy devices can shorten the learning curve of surgeons, reduce the rate of surgical complications, and further improve the overall level of laparoscopic radical gastrectomy in China.