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目的:探讨新辅助治疗后行胃癌根治术的患者术后并发症发生情况及其预后的影响因素。方法:采用回顾性病例队列研究方法。病例纳入标准：（1）组织病理学证实为胃腺癌；（2）术前影像学检查无远处转移或腹膜种植转移；（3）行新辅助治疗后接受胃癌根治术加Dn 2淋巴结清扫术；（4）临床病理及随访资料完整。根据以上标准，回顾性收集2008年1月至2018年12月期间，于中国医学科学院北京协和医学院肿瘤医院行胃癌根治术的490例胃癌患者的临床资料，其中男性358例，女性132例，年龄（55.0±10.6）岁。新辅助治疗方案包括SOX（替吉奥+奥沙利铂）151例，XELOX（希罗达+奥沙利铂）105例，FLOT（多西他赛+奥沙利铂+氟尿嘧啶）66例以及DOS（多西他赛+奥沙利铂+替吉奥）68例；术前行同步放化疗患者100例，采用SOX方案2~4周期诱导化疗加同步放化疗（三维适形调强放疗+替吉奥）。术后并发症指术后出现的手术相关并发症，主要包括术后出血、吻合口漏、术后梗阻、术后狭窄、肺部感染、腹腔感染等。根据Clavien-Dindo法评定术后并发症分级。采用log-rank检验进行预后单因素分析，采用Cox回归模型进行预后模型的多因素分析。n 结果:全组患者术后总并发症的发生率为17.8%（87/490，总计101例次），其中发生严重并发症者（Clavien-Dindo Ⅲ~Ⅴ级）29例，非严重并发症者（Clavien-Dindo Ⅰ~Ⅱ级）58例。多因素分析结果显示，年龄>65岁（HR=3.077，95% CI：1.827~5.184，n P 65 years (HR=3.077, 95% CI: 1.827-5.184, n P<0.001) and total gastrectomy (HR=1.735, 95% CI: 1.069-2.814,n P=0.026) were independent risk factors for postoperative complications in patients with gastric cancer undergoing neoadjuvant therapy and radical gastrectomy (both n P<0.05). The follow-up period was 0.7 to 131.8 months (median 21.5 months), and the 5-year overall survival rate was 47.4%. The 5-year overall survival rates of the complication group (87 cases) and the non-complication group (403 cases) were 33.2% and 50.9%, respectively (n P=0.001). Multivariate analysis showed that age (HR=1.906, 95% CI: 1.248-2.913, n P=0.003), ypTNM II to III stage (II stage: HR=5.853, 95% CI: 1.778-19.260, n P=0.004; III stage: HR=10.800, 95% CI: 3.411-34.189, n P3.5 h (HR=1.492, 95% CI: 1.095-2.033,n P=0.011), total gastrectomy (HR=1.657, 95% CI: 1.216-2.257, n P=0.001) and postoperative complications (HR=1.614, 95% CI: 1.125-2.315, n P=0.009) were independent risk factors for prognosis, and postoperative adjuvant therapy (HR=0.578, 95% CI: 0.421-0.794, n P=0.001) was an independent protective factor for prognosis.n Conclusions:The occurrence of postoperative complications in gastric cancer patients undergoing neoadjuvant therapy is closely related to the age of the patients and the range of surgical resection. It is beneficial to improve the prognosis for these patients by paying more attention to the prevention of postoperative complications and the reinforcement of postoperative adjuvant therapy.