腹腔镜与内镜联合手术（LECS）融合内镜精准切除与腹腔镜缝合清扫优势，实现胃肿瘤的精准定位、完整切除与功能保留。目前，LECS衍生出内镜辅助腹腔镜楔形切除术、腹腔镜辅助内镜全层切除术、非暴露技术等多种术式，各适用于不同部位、浸润深度及转移风险的病变，拓宽了适应证。临床证据表明，LECS治疗早期胃癌、胃间质瘤及特殊部位肿瘤安全有效，非暴露术式进一步降低腹腔污染与播散风险。未来，结合三维重建与人工智能辅助规划，有望优化淋巴结清扫决策并减少并发症，适应证或向更高风险分期审慎拓展。然而，其远期肿瘤学疗效仍需多中心、大样本、前瞻性研究提供高级别循证支持。

Laparoscopic and endoscopic cooperative surgery (LECS) combines the advantages of precise endoscopic resection and laparoscopic suturing and lymphadenectomy, enabling accurate tumor localization, complete resection, and function preservation. Currently, various derivative procedures have been developed, including endoscopy assisted laparoscopic wedge resection (EAWR), laparoscopy assisted endoscopic resection (LAER), and non exposure techniques (e.g., CLEAN-NET), each suitable for lesions at different locations, depths of invasion, and risks of metastasis, thereby broadening the indications. Clinical evidence has demonstrated that LECS is safe and effective for early gastric cancer, gastric stromal tumors, and tumors in special locations, and non exposure techniques further reduce the risks of peritoneal contamination and dissemination. In the future, with the integration of three dimensional reconstruction and artificial intelligence assisted planning, it is expected to optimize decision making for lymph node dissection and reduce complications, and indications may be cautiously extended to higher risk stages. However, its long term oncological outcomes still require high level evidence based support from multicenter, large sample, prospective studies.