Safety and Efficacy of Single or Reduced Ports Laparoscopic Gastrectomy for Advanced Gastric Cancer (SPACE-01)

Inclusion Criteria: * Patients who have confirmed that participants have advanced gastric cancer at clinical stage T2 or higher and who can undergo distal gastrectomy for primary gastric cancer who have consented to single-port and reduced-port laparoscopic gastric cancer surgery * Patients diagnosed with locally advanced gastric cancer in which no enlarged lymph nodes were observed in the preoperative examination, or lymph node metastases confined to the left gastric artery or perigastric area were suspected. * Those who have not been treated for systemic inflammatory disease before surgery Exclusion Criteria: * Those who have previously had gastrectomy. * Those who have a laparotomy except for appendectomy, cholecystectomy or cesarean section. * Patients with clinical (preoperative or intraoperative) stage T4b accompanied by infiltration of surrounding organs * Those with bulky lymph nodes (single nodules over 3 cm or multiple nodules over 1.5 cm) * Patients with confirmed distant metastasis (M1) * Severe liver cirrhosis * Patients who is judged by the investigator to be inappropriate for this study * Patients who are taking antithrombotic drugs, including antiplatelet drugs and anticoagulants, and cannot safely stop before surgery