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目的:探讨早期胃癌非治愈性内镜切除后行补救手术的必要性和安全性。方法:回顾性分析2013年1月至2020年1月北京协和医学院肿瘤医院56例早期胃癌在内镜下切除术后未达到治愈标准追加补救手术患者的临床病理及随访资料，评价补救手术的必要性和安全性。结果:本组56例患者内镜切除术后病理检查显示，肿瘤侵犯黏膜下层共44例(79%)，其中有38例(68%)侵犯黏膜下层深度超过500 μm，切缘阳性33例(59%)。补救手术后病理检查显示，6例(11%)有淋巴结转移，14例(25%)有肿瘤残留。多因素分析显示，更深的黏膜下层浸润是肿瘤残留的独立危险因素(n OR＝1.001，95% n CI＝1.000～1.002，n P＝0.036)。手术后发生并发症12例(21%)，出现腹腔或吻合口出血需要手术干预者3例(5%)。腹腔镜手术相比开腹手术在淋巴结清扫数目、术后并发症发生情况方面差异均无统计学意义(均n P>0.05)。n 结论:对于有淋巴结转移中高危因素的早期胃癌患者追加手术是有必要的；腹腔镜补救手术是早期胃癌非治愈性内镜切除患者安全可行的补救方式。“,”Objective:To evaluate salvage surgery in patients with early gastric cancer after noncurative endoscopic resection .Method:A total of 56 cases with early gastric cancer receiving salvage surgery after noncurative endoscopic resection were enrolled and the clinicopathological and follow-up information were analyzed to evaluate the necessity and safety of salvage surgery.Results:Among the 44(79%)patients with submucosal invasion, 38 (68%) were with SM2 (invasion submucosal invasion≥500 μm) according to the pathological results after endoscopic resection. 33 (59%)cases had positive margin. The rate of lymph node metastasis and positive residual tumor as found by salvage gastrectomy were 11% (6/56) and 25% (14/56) . In the multivariate analysis, deeper submucosal invasion resulted as independent risk factor for residual tumor( n OR=1.001, 95% n CI=1.000-1.002, n P=0.036). Among the 12(21%)cases with postoperative complications, 3 (5%)underwent unplanned reoperations because of anastomotic or intra-abdominal bleeding. There was no difference in the number of retrieved lymph nodes and rate of postoperative complications between laparoscopic and open surgery(all n P>0.05).n Conclusion:For patients with the risk factors of lymph node metastasis after noncurative endoscopic resection, salvage surgery was necessary and laparoscopic approach was safe and feasible.