To explore the clinical efficacy of laparoscopic radical resection via the right anterior approach versus the left posterior approach in the treatment of locally advanced gastric cancer (LAGC).

A total of 102 patients with LAGC who were scheduled to undergo laparoscopic radical resection in our hospital from February 2023 to May 2024 were prospectively enrolled. They were divided into the right group (undergoing the right anterior approach) and the left group (undergoing the left posterior approach) using a random number table method, with 51 patients in each group. Statistical analysis was performed using SPSS 25.0 software. For measurement data such as perioperative indicators and the number of dissected lymph nodes, the Kolmogorov-Smirnov (K-S) normality test was conducted first, and the data were expressed as (±s). The independent samples t test was used for inter-group comparison, and repeated-measures analysis of variance (ANOVA) was applied for repeated measurement data. Categorical data such as the positive margin rate and the incidence of postoperative complications were expressed as [cases (%)], and were analyzed using the χ² test, continuity-corrected χ² test, or Fisher’s exact test. P<0.05 was considered statistically significant.

There were no statistically significant differences between the two groups in terms of surgical incision length, number of dissected lymph nodes, number of positive lymph nodes, positive margin rate, or incidence of postoperative complications (all P>0.05). Compared with the left group, the right group had shorter operation time, less intraoperative blood loss, and lower Numerical Rating Scale (NRS) scores at all postoperative time points (all P<0.05).

Both laparoscopic radical resection via the right anterior approach and the left posterior approach can achieve favorable outcomes in the treatment of LAGC. However, compared with the left posterior approach, the right anterior approach has potential advantages, including shorter operation time, less intraoperative blood loss, and possibly lower postoperative pain intensity in patients.