Reducing Postoperative Diarrhea Risk in Gastric Cancer through Preserving the Celiac Branch of the Vagus Nerve

Preservation of the Celiac Branch of the Vagus Nerve Reduces the Incidence of Postoperative Diarrhea in Gastric Cancer: A Cohort Study

Introduction

The following is a summary of a study published in the April 2024 issue of Surgery by Guo et al. The study aimed to investigate the short-term and long-term outcomes associated with preserving the celiac branch of the vagus nerve during laparoscopic distal gastrectomy for gastric cancer.

Methods

A retrospective analysis was conducted on 149 patients diagnosed with gastric cancer who underwent laparoscopic-assisted distal gastrectomy (LADG) with Billroth-II anastomosis and D2 lymph node dissection between 2017 and 2018. Patients were categorized into two groups:

1. The preserved LADG group (P-LADG, n = 56) with preservation of the celiac branch of the vagus nerve.
2. The resected LADG group (R-LADG, n = 93) where the celiac branch was removed.

Propensity score matching was employed to select 56 patients in each group. Postoperative outcomes, including nutritional status, weight changes, short-term and long-term complications, and gallstone formation, were assessed over a 5-year follow-up period.

Results

Endoscopic evaluations at 12 months postoperatively determined residual gastritis and bile reflux status. The findings revealed a significantly lower incidence of postoperative diarrhea at the 5-year mark in the P-LADG group compared to the R-LADG group (p < 0.05).

Multivariate logistic regression analysis identified the vagus nerve celiac branch removal as an independent risk factor for postoperative diarrhea occurrence (odds ratio = 3.389, 95% confidence interval = 1.143-10.049, p = 0.028).

Conclusion

Preserving the celiac branch of the vagus nerve during LADG demonstrated a notable reduction in postoperative diarrhea incidence, presenting a valuable consideration in the surgical management of gastric cancer.

Source

wjso.biomedcentral.com/articles/10.1186/s12957-024-03370-0

SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 8: Decent Work and Economic Growth
• SDG 9: Industry, Innovation, and Infrastructure
• SDG 17: Partnerships for the Goals

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
• Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all
• Target 3.d: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction, and management of national and global health risks
• Target 8.5: By 2030, achieve full and productive employment and decent work for all women and men, including for young people and persons with disabilities, and equal pay for work of equal value
• Target 9.4: By 2030, upgrade infrastructure and retrofit industries to make them sustainable, with increased resource-use efficiency and greater adoption of clean and environmentally sound technologies and industrial processes
• Target 17.16: Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology, and financial resources, to support the achievement of the sustainable development goals in all countries, in particular developing countries

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

No, the article does not mention or imply any specific indicators that can be used to measure progress towards the identified targets.

4. SDGs, Targets, and Indicators