Vagal Sparing Gastrectomy: A Systematic Review and Meta-Analysis

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Comparative Effectiveness Research

Background:

• Radical gastrectomy can lead to significant functional complications.
• Vagal sparing gastrectomy (VSG) aims to preserve vagal trunks, potentially mitigating these complications.
• This review compares the functional and oncological outcomes of VSG versus conventional gastrectomy (CG).

Approach:

• A systematic review and meta-analysis of studies published between 1990 and 2021.
• PRISMA guidelines were followed for study selection and data extraction.
• Key outcomes analyzed include operative time, blood loss, nodal yield, and various functional complications.

Key Points:

• VSG demonstrated a lower incidence of cholelithiasis and dumping syndrome.
• Patients undergoing VSG experienced less blood loss and reduced long-term weight loss.
• Faster return of gut motility (time to flatus) was observed in the VSG group.

Conclusions:

• VSG significantly reduces post-operative cholelithiasis and dumping syndrome.
• VSG leads to decreased weight loss and earlier return of bowel function.
• Despite technical challenges, VSG is a recommended consideration for prophylactic surgery.