Objective:To retrospectively analyze the efficiency of laparoscopic and endoscopic cooperative surgery(LECS)for early gastric cancer treatment.Methods:We retrospectively collected data from patients with early gastric cancer who underwent LECS at the Peking University Cancer Hospital&Institute between May,2013 and April,2024.Patients underwent endoscopic submucosal dissection(ESD)with laparoscopic lymph node biopsy,classical LECS,and other modified procedures.Additionally,clinical and pathological characteristics,post-operative recovery indicators,complications,and survival outcomes of the patients were analyzed.Results:Nine patients(median age:64 years),including six male(66.7% )and three female(33.3% )patients,were involved in this study.Biopsy revealed that all patients had well-differentiated gastric cancer.Five patients(55.6% )underwent ESD with laparoscopic lymph node biopsy,and four patients(44.4% )under-went laparoscopically assisted endoscopic full-thickness resection and sentinel lymph node biopsy.Average anesthesia time was(351.2±91.4)min,and average blood loss was(34.4±15.1)mL.After surgery,three patients(33.3% )experienced complications,with one case each of gastric stasis(CD2),intra-abdominal infection(CD2),and gastrointestinal perforation(CD3).The median follow-up time was 52 months,and no cases of disease recurrence or death were observed.Conclusions:Overall,this study highlights the efficiency of LECS for early gastric cancer treatment.Future studies should assess its oncological safety,along with other technical aspects,patient selection criter-ia,and accuracy of sentinel lymph node biopsy,to facilitate widespread application of LECS.