Short Oral

Aim: Gastrectomy with lymphadenectomy is related with a high risk of postoperative complications, while it is still the cornerstone of curative treatment for gastric cancer patients.Significant changes have taken place in the treatment of gastric cancer in recent years, which challenges the safety of gastrectomy.This study is intended to reassess the safety of gastrectomy and the risk factors of postoperative complications under current clinical practice.Methods: Medical records of 2581 consecutive gastric cancer patients underwent gastrectomy between 2020 and 2021 were retrieved.A prospective data collecting system using AI was developed to facilitate the data collection and the identification of complications.Patient characteristics, surgical outcomes, and complications were collected and analyzed.Results: The present study showed a relatively low morbidity and mortality rate of 14.3% and 0.3%, respectively.The most common complications were pulmonary infection (5.9%), intra-abdominal fluid collection or abscess (2.6%) and deep vein thrombosis (2.6%).There were 74 (2.8%) cases of severe complications (grade III according to the Clavien-Dindo classification).The proportion of serious surgical complications decreased, while the proportion of potentially fatal medical complications increased.Multivariate analyses indicated that age over 80 years, comorbidity, proximal gastrectomy, combined resection and advanced tumor stage were independent risk factors of overall complications, and age over 80 years, comorbidity and combined resection were for severe complications. Conclusion:The safety of gastrectomy is improved in high-volume centers under current multimodality treatment mode.Measures like prehabilitation to prevent serious medical complications, instead of surgical complications, may be the focus to further reduce complications.