INTRODUCTION Splenectomy for proximal gastric cancer was found to offer no survival benefit in a randomized trial clarifying the role of splenectomy (JCOG0110 study). Although many studies have explored risk factors for morbidities following total gastrectomy, none have assessed the risk factors for postoperative complications in spleen-preserving total gastrectomy. METHODS Using data from 505 patients enrolled in a previous randomized trial, risk factors for postoperative complications were identified by multivariable logistic regression analysis. Then, the risk factors were assessed separately between splenectomy and spleen-preserving total gastrectomy. RESULTS Postoperative complications were identified in 119 patients (23.6%) and were more common following splenectomy than following spleen-preserving surgery (30.7% and 16.1%, respectively, p < 0.01). Multivariable analysis revealed that age ≥65 years (p = 0.032), body mass index ≥25 (p = 0.003), and blood loss ≥350 (p = 0.019) were independent risk factors for postoperative complications in the entire cohort. Among them, only body mass index was a significant independent risk factor for complications in both spleen preservation (p = 0.047) and splenectomy groups (p = 0.017). CONCLUSION Risk factors for postoperative complications were essentially the same between splenectomy and spleen preservation. Being overweight increased the risk of postoperative complications.

中文翻译：

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确定胃癌全胃切除术后并发症的危险因素：脾切除术与保脾手术的比较 - JCOG0110 的补充分析。

简介 在一项阐明脾切除术作用的随机试验（JCOG0110 研究）中，发现脾切除术治疗近端胃癌不会带来生存获益。尽管许多研究探讨了全胃切除术后发病的危险因素，但没有评估保脾全胃切除术后并发症的危险因素。方法 使用先前随机试验中纳入的 505 名患者的数据，通过多变量逻辑回归分析确定术后并发症的危险因素。然后，分别评估脾切除术和保脾全胃切除术的危险因素。结果 119 名患者 (23.6%) 发现术后并发症，脾切除术后并发症比保脾手术更常见（分别为 30.7% 和 16.1%，p < 0.01）。多变量分析显示，年龄≥65岁（p = 0.032）、体重指数≥25（p = 0.003）和失血量≥350（p = 0.019）是整个队列术后并发症的独立危险因素。其中，无论是保脾组（p = 0.047）还是脾切除组（p = 0.017），只有体重指数是并发症的显着独立危险因素。结论 脾切除与保留脾术后并发症的危险因素基本相同。超重会增加术后并发症的风险。