目的    探讨胃癌根治术后并发症的相关因素。方法    总结福建医科大学附属协和医院胃外科2007年1月至2012年6月间施行胃癌根治术的1876例病人的临床资料，统计分析术后并发症的发生情况并对影响因素进行单因素及多因素相关分析。结果    全组1876例病人中，发生术后并发症291例，术后并发症发生率为15.5%。单因素分析显示，肿瘤大小、术前合并症、浸润深度、淋巴结转移、手术时间、手术经验和是否采用腹腔镜手术与术后并发症发生密切相关（P＜0.05）。多因素相关分析显示，肿瘤大小、术前合并症、淋巴结转移、手术时间、手术经验和是否采用腹腔镜手术是影响术后并发症发生的独立危险因素（P＜0.05）。与无并发症病人相比，发生并发症者术后肛门排气时间较晚、住院时间较长（P＜0.05）。进一步分层分析发现，采用腹腔镜手术的病人术后外科并发症发生率与开腹手术者相当，但非外科并发症发生率低于开腹者（P＜0.05）。结论    影响胃癌根治术后并发症发生的独立危险因素为肿瘤大小、术前合并症、淋巴结转移、手术时间、手术经验和是否采用腹腔镜手术。腹腔镜手术能显著降低术后非外科并发症的发生率。

Postoperative complications and the risk factors of radical gastrectomy for gastric cancer        ZHENG Chao-Hui, LU Jun，HUANG Chang-Ming, et al. Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
Corresponding author: HUANG Chang-ming, E-mail: hcmlr2002@163.com
Abstract    Objective    To investigate the associated risk factors of postoperative complications in gastric cancer after radical gastrectomy. Methods    The clinical data of 1876 patients with gastric cancer performed radical gastrectomy from January 2007 to June 2012 were analyzed retrospectively. The risk factors determined postoperative complications were investigated by univariate and multivariate analysis. Results    The postoperative complications occurred in 291 (15.5%) of 1876 patients. According to univariate analysis, tumor size, preoperative comorbidity, depth of invasion, lymph node metastasis, operation time,surgeon’s experience and laparoscopic surgery were related to postoperative complications（P<0.05）. By logistic regression analysis，it was revealed that there were six significant factors for postoperative complications such as tumor size, preoperative comorbidity, lymph node metastasis, operation time,surgeon’s experience and laparoscopic surgery. The first flatus time and postoperative hospital stay in patients with postoperative complications were significantly longer than those in patients without postoperative complications （P<0.05）. The incidence of postoperative surgical complications of laparoscopic group and open group had no significant difference. However, postoperative non-surgical complication rate of laparoscopic group is lower significantly (P<0.05). Conclusion Tumor size, preoperative comorbidity, lymph node metastasis, operation time, surgeon’s experience and laparoscopic surgery were the main risk factors of postoperative complications in laparoscopy-assisted radical gastrectomy. Laparoscopic surgery can significantly reduce the incidence of postoperative non-surgical complications