Objective:To analyze and discuss the clinical significance of preoperative planning and guidance based on three-dimensional reconstruction of perigastric vessels in precision surgery for gastric cancer.Methods:A prospective study was conducted to analyze the data of 50 patients with gastric cancer who received surgical treatment in Jiangyin People′s Hospital from December 2020 to December 2022, including 35 males and 15 females, aged from 38 to 79 years old, with an average age of 66.3 years old. All patients were divided into control group ( n=25) and experimental group ( n=25) according to random number table method. Both groups underwent enhanced multi-slice spiral CT scan of the chest, abdomen and pelvis before surgery. The experimental group underwent 3D reconstruction based on CT data for preoperative planning and guidance, while the control group did not undergo 3D reconstruction. Patients in both groups received radical surgery for gastric cancer. Operation time, intraoperative blood loss, total postoperative drainage volume, postoperative hospital stay, number of lymph node dissection and postoperative complications were compared between the two groups. The statistical software SPSS27.0 was used to obtain the relevant data analysis results. Results:The intraoperative blood loss, total drainage volume and postoperative hospital stay of the experimental group were lower than those of the control group( P<0.05). The operative time, number of lymph node dissection and postoperative complications of the experimental group were not significantly different from those of the control group( P>0.05). Conclusions:Preoperative three-dimensional reconstruction of gastric perivascular with CT data can provide better preoperative evaluation, surgical planning and intraoperative guidance, reduce intraoperative accidental vascular injury, blood loss, total postoperative drainage and postoperative hospital stay. It has positive clinical application value to complete accurate radical resection of gastric cancer.