Objective: To study the feasibility, indication, and clinical significance of preserving the vagus nerve during esophagectomy for patients with cancer of the esophagus.
Methods: The digestive functions of the stomach were studied and compared before and after esophagectomy in patients with vagus nerve intact (n = 11) or severed (n = 12).
Results: According to Angorn's grading system, patients with vagus nerve preserved (VNP) had less symptoms after operation than those with vagus nerve severed (VNS). The gastric emptying time of the intrathoracic stomach in patients with VNS was much prolonged compared with that in patients with VNP. There was no significant difference in the preoperative and postoperative mean basal gastric acid output and the 24-hour pH monitoring in patients with VNP, while in VNS patients they were significantly decreased after operation. Fasting serum gastrin level in VNS patients was significantly elevated but this was not observed in VNP patients. Fibroptic endoscopic examination revealed higher incidence of postoperative atrophic gastritis in VNS than in VNP patients.
Conclusion: Preservation of the vagal trunks during surgical resection for cancer of the esophagus is beneficial to keep the postoperative digestive functions of the stomach in a better condition.