The effects of convenient vagorrhaphy on the early recovery of gastric secretion and emptying: an experimental study on function-preserving gastric cancer surgery.

Abstract

An experimental study was conducted using a canine model to elucidate whether the once transected vagal nerve can be conveniently anastomosed, and to determine when and to what degree the vagorrhaphy retains its functions. In the vagorrhaphy group (n = 5), the anterior and posterior vagal trunks were transected 1.5 cm above the diaphragma and the cut ends were anastomosed using two stitches of 8-0 nylon and fibria glue adhesive without microsurgery. In the nonvagorrhaphy group (n = 5), a 1-cm length of the nerve segment was resected to prevent reinnervation. A microscopic study of the anastomotic site performed on postoperative day (POD) 10 indicated the intervention of nerve fibers between the cut ends. No differences were found in the gastric secretory function, as assessed by the Hollander insulin test, or in the emptying function, as assessed by the acetaminophen test, between the vagorrhaphy group and the control preoperative values. However, both of these functions were superior in the vagorrhaphy group compared to the nonvagorrhaphy group. These results indicate that the technique of convenient vagal anastomosis could be put to practical use in gastric cancer operations to avoid postvagotomy syndrome.