Objective To compare the efficacy of traditional open surgical D2 gastrectomy and gastrectomy D2 laparoscopic. Methods 180 cases of gastric cancer patients were included in the study, in which 90 patients in the observation group took laparoscopy By assist D2 total gastrectomy, 90 patients in the control group are taking traditional open D2 total gastrectomy, surgical results between the two groups of patients. Results The patient's operation time blood loss, postoperative exhaust time, postoperative hospital stay were (254.3±26.5)min,(139.2±34.6)ml,(3.3±0.8)d,(10.3±1.5) d and significantly better than the control group of patients (207.3±24.6)min,(266.5±58.7)ml,(5.7±1.2)d、 (13.5±1.8)d, the difference was statistically significant (P<0.05) between the two groups, one month after surgery, abdominal mirror group of patients with CRP compared with traditional open a significant improvement in patients, the difference was statistically significant (P<0.05) between the two groups; tumor markers CEA two groups of patients, were significantly decreased CA199, CA125 water, and between-group differences no significant complication rate was observed in patients 15.5% (14/90), significantly lower than the control group of patients (28.9%), the difference was statistically significant (P<0.05) between the two groups. Conclusion Laparoscopic assisted radical total gastrectomy with D2 traditional open surgery has basically the same effect, but because of its minimally invasive laparoscopic characteristics, damage to the body is also significantly lower, less trauma to the patient, there is help patients early postoperative recovery, promote prognosis, worth clinical application.