Clinical influence of vagotomy on postoperative acute phase response.
BACKGROUND
Although there is increasing evidence suggesting that the vagus nerve functions as a connector between the nervous and immune systems in animals, little is known about the role of the vagus nerve in postoperative acute phase response in humans.


METHODS
The extent of fever and acute phase protein response and the production of inflammatory cytokine during the early postoperative period were compared among the patients who had undergone total gastrectomy including truncal vagotomy (n = 13), those having distal gastrectomy with division of vagal branches (n = 14), and the patients with vagal nerve preserving gastrectomy (n = 12).


RESULTS
There was no significant difference in serum levels of C-reactive protein, alpha-1-antirypsin, and interleukin-6 among the three groups. Also, postoperative maximum body temperature was similar.


CONCLUSIONS
Vagotomy did not influence acute phase response after gastric cancer surgery. A multipathway mechanism for acute phase response including the induction of fever is suggested.
Fujita
Tetsuji
T
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan. tetsu@jg8.so-net.ne.jp
Yanaga
Katsuhiko
K
D000210:Acute-Phase Reaction / Q000097:blood / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology* / Q000517:prevention & control; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D014628:Vagotomy; D014630:Vagus Nerve / Q000503:physiopathology*; D000515:alpha 1-Antitrypsin / Q000097:blood
D015850:Interleukin-6; D000515:alpha 1-Antitrypsin; D002097:C-Reactive Protein