A Gastrectomy for early-stage gastric cancer patients with or without preserving celiac branches of vagus nerves: A meta-analysis

Jin, Tao; Chen, Zehua; Liang, Pan-Ping; Li, Ze‐Dong; He, Feng-Jun; Chen, Zheng-Wen; Hu, Jian-Kun; Yang, Kun

doi:10.1016/j.surg.2022.10.016

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…In summary, vagotomy resulted in an increased deposition of tumors in the milky spots shortly after intraperitoneal inoculation of gastric cancer cells, ultimately leading to the augmentation of PM formation. Prior research has established that the preservation of the vagus nerve during surgery for early gastric cancer yields benefits such as a reduction in the incidence of gallstones, postoperative diarrhea, and bile reflux 57 – 59 . Conversely, for surgery targeting advanced gastric cancer, preserving the vagus nerve is considered impractical due to oncological safety, namely to prevent the risk of insufficient lymph node dissection.…”

Section: Discussionmentioning

confidence: 99%

Vagus nerve signal has an inhibitory influence on the development of peritoneal metastasis in murine gastric cancer

Futoh,

Miyato,

Yamaguchi

et al. 2024

Sci Rep

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The vagus nerve is the only pathway for transmitting parasympathetic signals between the brain and thoracoabdominal organs, thereby exhibiting anti-inflammatory functions through the cholinergic anti-inflammatory pathway. Despite often being resected during lymph node dissection in upper gastrointestinal cancer surgery, the impact of vagotomy on postoperative outcomes in gastric cancer patients remains unclear. Sub-diaphragmatic vagotomy was performed on C57BL/6 mice. Three weeks later, syngeneic murine gastric cancer cell line YTN16P was injected into the peritoneal cavity, and the number of peritoneal metastases (PM) on the mesentery and omentum compared with control mice. The phenotypes of immune cells in peritoneal lavage and omental milky spots one day after tumor inoculation were analyzed using flow cytometry and immunohistochemistry. Intraperitoneal transfer of 3 × 105 YTN16P significantly increased the number of metastatic nodules on the mesentery in the vagotomy group compared to the control group. The omental metastasis grade was also significantly higher in the vagotomy group. Phenotypic analysis of immune cells in peritoneal lavage did not reveal significant differences after vagotomy. However, vagotomized mice exhibited a notable increase in milky spot area, with a higher presence of cytokeratin(+) tumor cells, F4/80(+) macrophages, and CD3(+) T cells. Vagus nerve signaling appears to regulate the immune response dynamics within milky spots against disseminated tumor cells and inhibits the development of PM. Preserving the vagus nerve may offer advantages in advanced gastric cancer surgery to reduce peritoneal recurrence.

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Section: Discussionmentioning

confidence: 99%

Vagus nerve signal has an inhibitory influence on the development of peritoneal metastasis in murine gastric cancer

Futoh,

Miyato,

Yamaguchi

et al. 2024

Sci Rep

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“…The random-effects models were used to pool the effect estimates in this meta-analysis. The publication bias was assessed using a Begg's funnel chart using STATA (11). The source of heterogeneity was identified by sensitivity analysis or subgroup analysis.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for severe low anterior resection syndrome in patients with rectal cancer undergoing sphincter‑preserving resection: A systematic review and meta‑analysis

Xu,

Cheng,

Xiang

et al. 2023

Oncol Lett

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The present study aimed to evaluate the incidence and risk factors of severe low anterior resection syndrome (LARS) in patients with rectal cancer undergoing sphincter-preserving resection, and to provide the clinical basis and reference for the treatment of rectal cancer and the prevention of LARS. Studies on the incidence and risk factors for severe LARS in patients with rectal cancer undergoing sphincter-preserving resection were searched using PubMed, Embase, Cochrane Library, Scopus and Web of Science, according to the inclusion and exclusion criteria. After evaluating the study quality and extracting relevant data, RevMan 5.2 and STATA software were used to conduct a meta-analysis. A total of 12 articles were considered eligible for the present meta-analysis. Within these articles, there were 3,877 cases of sphincter-preserving resection for rectal cancer and 1,589 cases of severe LARS; the incidence of severe LARS was 40.99%. The results of the meta-analysis revealed that sex [female; odds ratio (OR),

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“…Gastric surgery is indicated in resectable T1b-T3 tumors using distal or total gastrectomy, based on the location and extent of the tumor. Gastrectomy with celiac branch vagus nerve-preserving technique has demonstrated benefits in early gastric cancer, leading to a reduced incidence of gallstones, bile reflux, shorter time of first flatus and shorter hospital stay, though AL rate remained similar [8]. Minimally invasive approaches, such as laparoscopic or robotic procedures can J Gastrointestin Liver Dis, December 2023 Vol.…”

Section: Introductionmentioning

confidence: 99%

Anastomotic Leakage after Gastrectomy for Gastric Cancer

Seicean,

Puscasu,

Gheorghiu

et al. 2023

JGLD

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Anastomotic leakage (AL) constitutes a prominent cause of significant morbidity following gastrectomy for gastric cancer. The manifestation of AL typically occurs within 7 to 10 days post-surgery, with reported incidence rates of 5.8-6.7% for open gastrectomy and 3.3-4.1% for laparoscopic gastrectomy. Various predisposing risk factors have been identified, including the individual nutritional status (excluding obesity) and preoperative corticotherapy. Interestingly, the administration of neoadjuvant therapies appears to reduce the AL occurrence. In the context of distal gastrectomies, the rates of AL are comparable between laparoscopic, robotic, and open approaches. The total gastrectomies have higher AL rate compared to distal gastrectomies, which are considered the preferred approach. Prophylactic drainage measures have not demonstrated efficacy in preventing AL. As for postoperative management, conservative treatment is indicated for patients presenting with mild clinical symptoms and increased inflammatory blood tests. This approach involves fasting, enteral or parenteral nutrition, administration of antibiotics, and percutaneous drainage. For small AL, endoscopic therapies such as stents, vacuum therapy, clips, suturing devices, and injections are appropriate treatment options. In cases of high-volume fistulas, severe sepsis or failure of previous therapies, surgical reoperation becomes the ultimate solution.

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A Gastrectomy for early-stage gastric cancer patients with or without preserving celiac branches of vagus nerves: A meta-analysis

Cited by 5 publications

References 21 publications

Vagus nerve signal has an inhibitory influence on the development of peritoneal metastasis in murine gastric cancer

Vagus nerve signal has an inhibitory influence on the development of peritoneal metastasis in murine gastric cancer

Risk factors for severe low anterior resection syndrome in patients with rectal cancer undergoing sphincter‑preserving resection: A systematic review and meta‑analysis

Anastomotic Leakage after Gastrectomy for Gastric Cancer

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