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Significance of preserving vagus nerve in ileocolon interposition after total gastrectomy.

BACKGROUND/AIMS
We have performed ileocolon interposition for reconstruction (IR) after total gastrectomy in order to reduce postoperative symptoms such as heartburn, reflux esophagitis and nutritional disturbance. After IR, however, the frequency of diarrhea increased in the postoperative period. We therefore investigated whether post-IR diarrhea could be prevented by preserving the vagus nerve.


METHODOLOGY
The vagus nerve was not preserved in 46 (non-PV group) stage I and II gastric cancer patients treated with the IR method, and preserved in 28 for stage IA (PV group). By means of a mailed and interviewed questionnaire, we surveyed the patients at six months postoperatively to examine how diarrhea had occurred in either group.


RESULTS
The frequency of diarrhea of the PV group was as low as 26% (7/27) which was significantly lower than 76% (35/46) of the non-PV group.


CONCLUSIONS
Preservation of the vagus nerve during reconstruction using ileocolon interposition after total gastrectomy for stage IA is a superior approach for the prevention of postoperative diarrhea.