{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T01:10:03Z","timestamp":1747962603269},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T00:00:00Z","timestamp":1712361600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T00:00:00Z","timestamp":1712361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>To investigate the short-term and long-term outcomes of preserving the celiac branch of the vagus nerve during laparoscopic distal gastrectomy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 149 patients with prospective diagnosis of gastric cancer who underwent laparoscopic-assisted distal gastrectomy (LADG) combined with Billroth-II anastomosis and D2 lymph node dissection between 2017 and 2018 were retrospectively analyzed. The patients were divided into the preserved LADG group (P-LADG, <jats:italic>n<\/jats:italic>\u2009=\u200956) and the resected LADG group (R-LADG, <jats:italic>n<\/jats:italic>\u2009=\u200993) according to whether the vagus nerve celiac branch was preserved. We selected 56 patients (P-LADG, <jats:italic>n<\/jats:italic>\u2009=\u200956) with preservation of the celiac branch of the vagus nerve and 56 patients (R-LADG, <jats:italic>n<\/jats:italic>\u2009=\u200956) with removal of the celiac branch of the vagus nerve by propensity-matched score method. Postoperative nutritional status, weight change, short-term and long-term postoperative complications, and gallstone formation were evaluated in both groups at 5\u00a0years of postoperative follow-up. The status of residual gastritis and bile reflux was assessed endoscopically at 12\u00a0months postoperatively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The incidence of diarrhea at 5\u00a0years postoperatively was lower in the P-LADG group than in the R-LADG group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). In the multivariate logistic analysis, the removal of vagus nerve celiac branch was an independent risk factor for the occurrence of postoperative diarrhea (odds ratio\u2009=\u20093.389, 95% confidential interval\u2009=\u20091.143-10.049, <jats:italic>p<\/jats:italic>\u2009=\u20090.028). In the multivariate logistic analysis, the removal of vagus nerve celiac branch was an independent risk factor for the occurrence of postoperative diarrhea (odds ratio\u2009=\u20094.371, 95% confidential interval\u2009=\u20091.418-13.479, <jats:italic>p<\/jats:italic>\u2009=\u20090.010).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Preservation of the celiac branch of the vagus nerve in LADG reduced the incidence of postoperative diarrhea postoperatively in gastric cancer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>This study was registered with the Ethics Committee of the First Affiliated Hospital of Dalian Medical University in 2014 under the registration number: LCKY2014-04(X).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12957-024-03370-0","type":"journal-article","created":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T05:01:24Z","timestamp":1712379684000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Preservation of the celiac branch of the vagus nerve reduces the incidence of postoperative diarrhea in gastric cancer: a cohort study"],"prefix":"10.1186","volume":"22","author":[{"given":"Hao","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"WeiFeng","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HaiTao","family":"Duan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MaoHua","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pin","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,6]]},"reference":[{"key":"3370_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71:209\u201349.","journal-title":"CA Cancer J Clin"},{"key":"3370_CR2","doi-asserted-by":"publisher","first-page":"101404","DOI":"10.1016\/j.eclinm.2022.101404","volume":"47","author":"E Morgan","year":"2022","unstructured":"Morgan E, Arnold M, Camargo MC, Gini A, Kunzmann AT, Matsuda T, et al. The current and future incidence and mortality of gastric cancer in 185 countries, 2020\u201340: A population-based modelling study. EClinicalMedicine. 2022;47:101404.","journal-title":"EClinicalMedicine"},{"key":"3370_CR3","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1053\/j.gastro.2017.01.029","volume":"152","author":"JK Jun","year":"2017","unstructured":"Jun JK, Choi KS, Lee HY, Suh M, Park B, Song SH, et al. Effectiveness of the Korean National Cancer Screening Program in Reducing Gastric Cancer Mortality. Gastroenterology. 2017;152:1319-1328.e1317.","journal-title":"Gastroenterology"},{"key":"3370_CR4","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1038\/bjc.2014.608","volume":"112","author":"KS Choi","year":"2015","unstructured":"Choi KS, Jun JK, Suh M, Park B, Noh DK, Song SH, et al. Effect of endoscopy screening on stage at gastric cancer diagnosis: results of the National Cancer Screening Programme in Korea. Br J Cancer. 2015;112:608\u201312.","journal-title":"Br J Cancer"},{"key":"3370_CR5","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.1200\/JCO.2015.63.7215","volume":"34","author":"Y Hu","year":"2016","unstructured":"Hu Y, Huang C, Sun Y, Su X, Cao H, Hu J, et al. Morbidity and Mortality of Laparoscopic Versus Open D2 Distal Gastrectomy for Advanced Gastric Cancer: A Randomized Controlled Trial. J Clin Oncol. 2016;34:1350\u20137.","journal-title":"J Clin Oncol"},{"key":"3370_CR6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12957-020-1795-1","volume":"18","author":"F Zeng","year":"2020","unstructured":"Zeng F, Chen L, Liao M, Chen B, Long J, Wu W, et al. Laparoscopic versus open gastrectomy for gastric cancer. World J Surg Oncol. 2020;18:20.","journal-title":"World J Surg Oncol"},{"key":"3370_CR7","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1016\/j.jamcollsurg.2006.02.028","volume":"202","author":"SI Lee","year":"2006","unstructured":"Lee SI, Choi YS, Park DJ, Kim HH, Yang HK, Kim MC. Comparative study of laparoscopy-assisted distal gastrectomy and open distal gastrectomy. J Am Coll Surg. 2006;202:874\u201380.","journal-title":"J Am Coll Surg"},{"key":"3370_CR8","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/PL00011730","volume":"4","author":"H Yano","year":"2001","unstructured":"Yano H, Monden T, Kinuta M, Nakano Y, Tono T, Matsui S, et al. The usefulness of laparoscopy-assisted distal gastrectomy in comparison with that of open distal gastrectomy for early gastric cancer. Gastric Cancer. 2001;4:93\u20137.","journal-title":"Gastric Cancer"},{"key":"3370_CR9","doi-asserted-by":"publisher","first-page":"2676","DOI":"10.1245\/s10434-013-2930-9","volume":"20","author":"T Fukunaga","year":"2013","unstructured":"Fukunaga T, Hiki N, Kubota T, Nunobe S, Tokunaga M, Nohara K, et al. Oncologic outcomes of laparoscopy-assisted distal gastrectomy for gastric cancer. Ann Surg Oncol. 2013;20:2676\u201382.","journal-title":"Ann Surg Oncol"},{"key":"3370_CR10","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.jss.2019.07.074","volume":"245","author":"Y Liu","year":"2020","unstructured":"Liu Y, Cui X, Zhang Y, Cao L, Hu X. Efficacy of Celiac Branch Preservation in Billroth-I Reconstruction After Laparoscopy-Assisted Distal Gastrectomy. J Surg Res. 2020;245:330\u20137.","journal-title":"J Surg Res"},{"key":"3370_CR11","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1097\/SLA.0000000000001565","volume":"263","author":"SM Kim","year":"2016","unstructured":"Kim SM, Cho J, Kang D, Oh SJ, Kim AR, Sohn TS, et al. A Randomized Controlled Trial of Vagus Nerve-preserving Distal Gastrectomy Versus Conventional Distal Gastrectomy for Postoperative Quality of Life in Early Stage Gastric Cancer Patients. Ann Surg. 2016;263:1079\u201384.","journal-title":"Ann Surg"},{"key":"3370_CR12","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.jss.2010.08.040","volume":"173","author":"H Miyato","year":"2012","unstructured":"Miyato H, Kitayama J, Hidemura A, Ishigami H, Kaisaki S, Nagawa H. Vagus nerve preservation selectively restores visceral fat volume in patients with early gastric cancer who underwent gastrectomy. J Surg Res. 2012;173:60\u20137.","journal-title":"J Surg Res"},{"key":"3370_CR13","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1007\/s10120-020-01106-z","volume":"24","author":"CJ Wang","year":"2021","unstructured":"Wang CJ, Kong SH, Park JH, Choi JH, Park SH, Zhu CC, et al. Preservation of hepatic branch of the vagus nerve reduces the risk of gallstone formation after gastrectomy. Gastric Cancer. 2021;24:232\u201344.","journal-title":"Gastric Cancer"},{"key":"3370_CR14","doi-asserted-by":"publisher","first-page":"2119","DOI":"10.1007\/s00268-009-0147-7","volume":"33","author":"R Tomita","year":"2009","unstructured":"Tomita R. Gastric emptying function in patients 5 years after pylorus-preserving distal gastrectomy with or without preserving pyloric and hepatic branches of the vagal nerve for early gastric cancer. World J Surg. 2009;33:2119\u201326.","journal-title":"World J Surg"},{"issue":"20","key":"3370_CR15","first-page":"1","volume":"2017","author":"Japanese gastric cancer treatment guidelines","year":"2014","unstructured":"Japanese gastric cancer treatment guidelines. ver.4. Gastric Cancer. 2014;2017(20):1\u201319.","journal-title":"Gastric Cancer."},{"key":"3370_CR16","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1007\/s10120-004-0269-4","volume":"7","author":"H Nagano","year":"2004","unstructured":"Nagano H, Ohyama S, Sakamoto Y, Ohta K, Yamaguchi T, Muto T, et al. The endoscopic evaluation of gastritis, gastric remnant residue, and the incidence of secondary cancer after pylorus-preserving and transverse gastrectomies. Gastric Cancer. 2004;7:54\u20139.","journal-title":"Gastric Cancer"},{"key":"3370_CR17","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.surg.2010.03.002","volume":"149","author":"H Yamada","year":"2011","unstructured":"Yamada H, Kojima K, Inokuchi M, Kawano T, Sugihara K. Efficacy of celiac branch preservation in Roux-en-y reconstruction after laparoscopy-assisted distal gastrectomy. Surgery. 2011;149:22\u20138.","journal-title":"Surgery"},{"key":"3370_CR18","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1007\/s00268-003-6906-y","volume":"27","author":"R Tomita","year":"2003","unstructured":"Tomita R, Fujisaki S, Tanjoh K. Pathophysiological studies on the relationship between postgastrectomy syndrome and gastric emptying function at 5 years after pylorus-preserving distal gastrectomy for early gastric cancer. World J Surg. 2003;27:725\u201333.","journal-title":"World J Surg"},{"key":"3370_CR19","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.ad.2019.05.009","volume":"112","author":"A Freites-Martinez","year":"2021","unstructured":"Freites-Martinez A, Santana N, Arias-Santiago S, Viera A. Using the Common Terminology Criteria for Adverse Events (CTCAE - Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies. Actas Dermosifiliogr (Engl Ed). 2021;112:90\u20132.","journal-title":"Actas Dermosifiliogr (Engl Ed)."},{"issue":"Pt 2","key":"3370_CR20","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1113\/jphysiol.1997.sp021873","volume":"498","author":"FJ Miao","year":"1997","unstructured":"Miao FJ, J\u00e4nig W, Levine JD. Vagal branches involved in inhibition of bradykinin-induced synovial plasma extravasation by intrathecal nicotine and noxious stimulation in the rat. J Physiol. 1997;498(Pt 2):473\u201381.","journal-title":"J Physiol"},{"key":"3370_CR21","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1540\/jsmr.31.33","volume":"31","author":"Y Yunoki","year":"1995","unstructured":"Yunoki Y. Effects of resection of celiac and pyloric branches of vagus nerve on the interdigestive motor activity of the upper digestive tract and biliary tree. J Smooth Muscle Res. 1995;31:33\u201341.","journal-title":"J Smooth Muscle Res"},{"key":"3370_CR22","doi-asserted-by":"publisher","first-page":"3252","DOI":"10.1245\/s10434-009-0646-7","volume":"16","author":"SH Kong","year":"2009","unstructured":"Kong SH, Kim JW, Lee HJ, Kim WH, Lee KU, Yang HK. The safety of the dissection of lymph node stations 5 and 6 in pylorus-preserving gastrectomy. Ann Surg Oncol. 2009;16:3252\u20138.","journal-title":"Ann Surg Oncol"},{"key":"3370_CR23","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1007\/s10120-017-0776-8","volume":"21","author":"H Furukawa","year":"2018","unstructured":"Furukawa H, Ohashi M, Honda M, Kumagai K, Nunobe S, Sano T, et al. Preservation of the celiac branch of the vagal nerve for pylorus-preserving gastrectomy: is it meaningful? Gastric Cancer. 2018;21:516\u201323.","journal-title":"Gastric Cancer"},{"key":"3370_CR24","doi-asserted-by":"publisher","first-page":"2003","DOI":"10.1007\/s00464-008-0016-8","volume":"22","author":"K Kojima","year":"2008","unstructured":"Kojima K, Yamada H, Inokuchi M, Kawano T, Sugihara K. Functional evaluation after vagus-nerve-sparing laparoscopically assisted distal gastrectomy. Surg Endosc. 2008;22:2003\u20138.","journal-title":"Surg Endosc"},{"key":"3370_CR25","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.jamcollsurg.2004.07.035","volume":"200","author":"I Uyama","year":"2005","unstructured":"Uyama I, Sakurai Y, Komori Y, Nakamura Y, Syoji M, Tonomura S, et al. Laparoscopic gastrectomy with preservation of the vagus nerve accompanied by lymph node dissection for early gastric carcinoma. J Am Coll Surg. 2005;200:140\u20135.","journal-title":"J Am Coll Surg"},{"key":"3370_CR26","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1080\/110241599750007306","volume":"165","author":"T Ichikura","year":"1999","unstructured":"Ichikura T, Tomimatsu S, Okusa Y, Mochizuki H. Improved physical condition by limiting lymphadenectomy around the coeliac artery after distal gastrectomy for gastric cancer. Eur J Surg. 1999;165:123\u201332.","journal-title":"Eur J Surg"},{"key":"3370_CR27","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1002\/bjs.1800711015","volume":"71","author":"CJ Stoddard","year":"1984","unstructured":"Stoddard CJ, Johnson AG, Duthie HL. The four to eight year results of the Sheffield trial of elective duodenal ulcer surgery\u2013highly selective or truncal vagotomy? Br J Surg. 1984;71:779\u201382.","journal-title":"Br J Surg"},{"key":"3370_CR28","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1136\/gut.29.3.312","volume":"29","author":"JD O'Brien","year":"1988","unstructured":"O\u2019Brien JD, Thompson DG, McIntyre A, Burnham WR, Walker E. Effect of codeine and loperamide on upper intestinal transit and absorption in normal subjects and patients with postvagotomy diarrhoea. Gut. 1988;29:312\u20138.","journal-title":"Gut"},{"key":"3370_CR29","first-page":"205","volume":"82","author":"VW Chan","year":"1996","unstructured":"Chan VW. Chronic diarrhea: an uncommon side effect of celiac plexus block. Anesth Analg. 1996;82:205\u20137.","journal-title":"Anesth Analg"},{"key":"3370_CR30","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1136\/gut.39.5.748","volume":"39","author":"L Rosa-e-Silva","year":"1996","unstructured":"Rosa-e-Silva L, Troncon LE, Oliveira RB, Foss MC, Braga FJ, Gallo JL. Rapid distal small bowel transit associated with sympathetic denervation in type I diabetes mellitus. Gut. 1996;39:748\u201356.","journal-title":"Gut"},{"key":"3370_CR31","doi-asserted-by":"publisher","first-page":"2172","DOI":"10.1007\/s00268-013-2078-6","volume":"37","author":"S Takiguchi","year":"2013","unstructured":"Takiguchi S, Hiura Y, Takahashi T, Kurokawa Y, Yamasaki M, Nakajima K, et al. Preservation of the celiac branch of the vagus nerve during laparoscopy-assisted distal gastrectomy: impact on postprandial changes in ghrelin secretion. World J Surg. 2013;37:2172\u20139.","journal-title":"World J Surg"}],"container-title":["World Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-024-03370-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12957-024-03370-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-024-03370-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T05:01:43Z","timestamp":1712379703000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjso.biomedcentral.com\/articles\/10.1186\/s12957-024-03370-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,6]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3370"],"URL":"https:\/\/doi.org\/10.1186\/s12957-024-03370-0","relation":{},"ISSN":["1477-7819"],"issn-type":[{"value":"1477-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,6]]},"assertion":[{"value":"26 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was registered with the Ethics Committee of the First Affiliated Hospital of Dalian Medical University in 2014 under the registration number: LCKY2014-04(X). Patients and their families voluntarily participated in this study have signed the informed consent forms.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from patients for all information.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"87"}}