Background: This study was designed to identify risk factors and oncological value for the development of postoperative complications after gastrectomy in gastric cancer patients with preoperative chemotherapy. Methods: A total of 123 gastric cancer patients who underwent gastrectomy after chemotherapy were enrolled in this study. The incidence, type, risk factors, and prognostic value of surgical complications were evaluated. Results: The postoperative complication rate was 29.3% and mortality rate was 1.6%. The development of postoperative complications was associated with operation time (>200 min) and transfusion during surgery. The resection extent, preoperative chemotherapy cycles and regimens, tumor stage, and patients' nutritional status were not predictive factors for the development of surgical complications. In the multivariate analysis, operation time was an independent risk factor for the development of postoperative complications (odds ratio, 3.813; P = 0.011). The median follow-up after surgery was 19 months. The 3-year, disease-free survival was 57.1% in patients without complications and 25.7% in patients with complications (P = 0.004). Multivariable analysis demonstrated postoperative complications were a significant prognostic factor for disease-free survival (hazard ratio, 2.676; P = 0.024). Conclusions: The incidence of surgical complications was high in gastric cancer patients who received preoperative chemotherapy. Long operation time was a risk factor for surgical complications, and the development of postoperative complication was predictive of patients' prognoses.
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