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Vagal integrity in vagal-sparing esophagectomy: a cadaveric study
F A M Herbella1, C V S Regatieri, D G Moreno
1Department of Surgery, Esophagus Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP Brazil. herbella.dcir@unifesp.epm.br
Summary
Vagal-sparing esophagectomy preserves vagus nerves despite anatomical variations in the mediastinum. This study confirms the feasibility of preserving vagal integrity during this surgical approach.
Area of Science:
- Anatomy
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Esophagectomy often leads to complications, some linked to vagotomy.
- Vagal-sparing esophagectomy offers an alternative, but vagal nerve integrity post-procedure requires further validation.
- The mediastinal vagus nerve's anatomy is not well-understood.
Purpose of the Study:
- To investigate the anatomical variations of the vagus nerve in the mediastinum.
- To evaluate the preservation of vagal nerve integrity during vagal-sparing esophagectomy in a cadaveric model.
Main Methods:
- Anatomical study of the vagus nerve in 30 fresh cadavers.
- Performance of vagal-sparing esophagectomy in 20 cadavers.
- Assessment of vagal nerve integrity after the surgical procedure.
Main Results:
- All cadavers exhibited one or more vagal trunks.
- Four anatomical patterns of the vagus nerve were identified (Types I-IV).
- Vagal nerve preservation was achieved in all 20 esophagectomy cases, with no operative accidents noted.
Conclusions:
- Vagal-sparing esophagectomy successfully preserves vagal nerves.
- Vagal nerve preservation is feasible regardless of the specific mediastinal vagal anatomy.
- This technique is a viable alternative to conventional esophagectomy, minimizing vagal injury.
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