Purpose
The aim of this study was to evaluate the impact of perioperative nutrition and transfusion affecting postoperative complications in gastric surgery.

Methods
From January through December in 2013, 181 patients who underwent curative gastrectomy for gastric adenocarcinoma at Korea University Guro Hospital were included. We collected general information, nutritional parameters (serum albumin, total lymphocyte counts, hemoglobin and body mass index (BMI)), operative method, perioperative transfusion and postoperative complications. The patients were divided into two groups by Clavien-Dindo classification; group I: no complication and Grade I complication, group II: above Grade II complication. We analyzed the factors affecting postoperative complications between two groups.

Results
The mean age of patients was 62.06 years, and 119(65.7%) patients were men. The patients suffering complications were 81(44.8%), group I was 138(76.2%) and group II was 43(23.8%). According to the results of univariate analysis, sex, age, comorbidities, the American Society Anesthesiologists` (ASA) classification and operative method had no significant effect on postoperative complications. Also in nutritional factors, serum albumin, total lymphocyte counts, hemoglobin had no significant correlation with postoperative complications. In contrast, BMI and perioperative transfusion had significant association with postoperative complications. BMI and perioperative transfusion were the only independent risk factors by multivariate analysis. The existence of comorbidities and serum albumin levels were not independent risk factors but associated with the increase in postoperative complications.

Conclusions
In this study, BMI in the nutritional factors and perioperative transfusion had an association in univariate analysis and independent risk factors in multivariate analysis with postoperative complications. This study was a retrospective study using a single biochemical indicators due to the difficulty of evaluating the overall nutritional status. However in the future a prospective study using multiple factors evaluating the nutritional status should be followed by multi-institutional prospective study to evaluate the effect of transfusion on gastrectomy.