双镜联合手术（LECS）的目的是在追求根治的同时最大限度保留胃的功能与病人生活质量。食管胃结合部、贲门、胃后壁、胃角及胃窦等特殊部位的胃肿瘤，因解剖结构复杂、毗邻关系特殊、操作空间受限，单纯内镜或腹腔镜手术均存在明显局限性。LECS通过整合内镜的腔内精准定位与腹腔镜下微创操作及缝合止血能力，在上述部位的治疗中具有独特优势，但其临床适用范围仍有明确边界。真正的挑战并非在于技术层面的可操作性，而在于能否为每一例病人制定个体化的治疗策略：有淋巴结转移风险时，应规范行淋巴结清扫；在无功能损害指征时，则应审慎控制切除范围，避免过度治疗。

The aim of laparoscopic and endoscopic cooperative surgery (LECS) is to pursue radical resection while maximizing preservation of gastric function and the patient’s quality of life. For gastric tumors located in special sites—such as the esophagogastric junction, cardia, posterior gastric wall, gastric angle (incisura angularis), and antrum—the complex anatomy, special adjacent relationships, and limited operative space impose significant limitations on both pure endoscopic and pure laparoscopic approaches. LECS integrates the precise intraluminal localization of endoscopy with the minimally invasive manipulation and suturing/hemostatic capabilities of laparoscopy, thus offering unique advantages in treating tumors at these sites. However, its clinical indications remain clearly defined. The real challenge is not technical feasibility, but whether an individualized treatment strategy can be developed for each patient: when there is a risk of lymph node metastasis, standardized lymph node dissection should be performed; when there is no indication of functional compromise, the extent of resection should be carefully controlled to avoid overtreatment.