术后并发症的长期影响，特别是胃切除术后胃癌患者的非癌症相关死亡率仍不清楚。我们的目的是评估这些并发症对非癌症相关死亡的影响。在日本一家医院接受胃癌根治性胃切除术的 236 名患者的队列根据 Clavien-Dindo II 级或更高级别的并发症进行分组。 Kaplan-Meier 方法、时序检验和 Cox 风险比分析用于评估无复发生存率和总生存率，并确定并发症和生存预测因素。谵妄是最常见的并发症（52 名患者中的 21 名）。总生存率存在显着差异（有并发症，3 年：58.1% 和 5 年：51.6%；无并发症，3 年：82.3% 和 5 年：73.6%；P < .001），但不包括无复发生存率（有并发症，3 年：77.8% 和 5 年：77.8%；无并发症，3 年：87.5% 和 5 年：85.2%）。非癌症相关死亡（主要由肺炎引起）在并发症组中比非并发症组更常见。美国麻醉医师协会身体状况评分高、输血、开放手术、男性、全胃切除术以及神经/精神疾病史等因素与总生存率下降独立相关。术后并发症影响长期预后，导致总体生存率下降，非癌症死亡率增加。积极主动的策略（包括优化术前管理、预防并发症和出院后干预）至关重要，重点是肺部疾病预防，以改善胃切除术后的预后。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Long-term implications of postoperative complications, particularly non-cancer-related mortality in patients with gastric cancer following gastrectomy, remain unclear. We aimed to evaluate the impact of these complications on non-cancer-related deaths.A cohort of 236 patients who underwent curative gastrectomy for gastric cancer in a Japanese hospital was divided based on complications classified as Clavien-Dindo grade II or higher. The Kaplan-Meier method, log-rank tests, and Cox hazard ratio analysis were used to evaluate recurrence-free survival and overall survival and to identify complications and survival predictors.Delirium was the most common complication (21 of 52 patients). A significant difference was observed in the overall survival (with complications, 3-year: 58.1% and 5-year: 51.6%; without complications, 3-year: 82.3% and 5-year: 73.6%; P < .001) but not in recurrence-free survival (with complications, 3-year: 77.8% and 5-year: 77.8%; without complications, 3-year: 87.5% and 5-year: 85.2%). Non-cancer-related deaths, predominantly resulting from pneumonia, were more prevalent in the complications group than in the noncomplications group. Factors, including high American Society of Anesthesiologists Physical Status scores, blood transfusion, open surgery, male sex, total gastrectomy, and a history of neurologic/psychiatric disease, were independently associated with decreased overall survival.Postoperative complications affect long-term prognosis, resulting in decreased overall survival and increased noncancer mortality. Proactive strategies, including optimizing preoperative management, preventing complications, and postdischarge interventions, are essential, with a focus on pulmonary disease prevention to improve prognosis after gastrectomy.Copyright © 2024 Elsevier Inc. All rights reserved.