关键词: 新辅助化疗, 腹腔镜胃癌根治术, 并发症, 影响因素, 预后

Abstract: Objective To investigate the factors related to the complications of laparoscopic radical gastrectomy after neoadjuvant chemotherapy and its influence on the prognosis. Methods The clinical data of 102 patients who underwent laparoscopic radical gastrectomy after neoadjuvant chemotherapy from May 2017 to May 2019 were retrospectively analyzed,Clavien Dindo method was used to evaluate the incidence of postoperative complications.Single factor and multi factor logistic regression analysis were used to explore the influencing factors of postoperative complications;Kaplan Meier survival curve was used to observe the 3 year overall survival rate of patients with or without complications. Results Postoperative complications occurred in 23 of 102 patients (22.55%),including 13 cases of Clavien Dindo grade Ⅱ,5 cases of grade Ⅲa and Ⅲb,3 cases of grade Ⅳ and 2 cases of grade Ⅴ.Univariate analysis showed that age,body mass index (BMI),operation time and scope of gastrectomy were related to postoperative complications (P<0.05);Multivariate logistic regression analysis showed that age≥60 (OR=2.395,95%CI=1.270-4.516),BMI≥24kg/m2 (OR=3.487,95%CI=1.037-11.725),operation time≥3.5h (OR=1.781,95%CI=1.064-2.982),and total gastrectomy (OR=1.709,95%CI=1.125-2.596) were independent risk factors for postoperative complications (P<0.05);Kaplan Meier survival curve analysis showed that the 3 year overall survival rate of patients with complications was 43.48%,which was lower than that of patients without complications (Log Rank χ2＝5.532,P＝0.019). Conclusion The occurrence of complications of laparoscopic radical gastrectomy after neoadjuvant chemotherapy is closely related to the patient’s age,BMI,operation time and scope of gastrectomy,and the prognosis of patients with postoperative complications is poor.Clinical attention should be paid to the prevention of postoperative complications.

Key words: neoadjuvant chemotherapy, laparoscopic radical gastrectomy, complication, Influencing factors, prognosis