title: Vagus nerve preservation results in visceral fat maintenance after distal gastrectomy.
abstract: OBJECTIVE
  Although preservation of the vaguas nerve is recommended in surgery for earlystage gastric cancer, the physiological effect of vagotomy on the postoperative course has not been well documented. We assessed the effect of vagotomy on the change in fat volume after gastrectomy.
  
  
  METHODS
  Subcutaneous fat area (SFA) and visceral fat area (VFA) were separately measured in computed tomographic images taken before and more than 6 months after surgery, using Fat Scan software. The ratios of postoperative/ preoperative values of these two fat areas as well as body weight were calculated in 45 patients who underwent DG with (n=24) or without (n=21) vagotomy.
  
  
  RESULTS
  Vagotomy did not affect the change in body weight (91.3±1.7% vs. 92.1±1.7%). In patients with vagotomy, VFA was reduced to 59.0±5.1%, which was significantly greater than the reduction in SFA (74.3±8.7%, p=0.042). In contrast, the reduction ratios of VFA and SFA were equal in vagus nerve-preserved patients (78.4±6.7% vs. 78.2±6.9%, p=0.97).
  
  
  CONCLUSIONS
  The vagus nerve may have a function to locally regulate the intra-abdominal fat volume and preservation of the vagus nerve results in the maintenance of visceral fat after DG.
authors.affiliation: Department of Surgery, University of Tokyo, Tokyo, Japan. hmiya-tky@umin.ac.jp
authors.forename: Hideyo
authors.initials: H
authors.lastname: Miyato
authors.forename: Joji
authors.initials: J
authors.lastname: Kitayama
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagawa
mesh_terms: D000368:Aged; D001835:Body Weight; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000294:innervation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D050151:Subcutaneous Fat / Q000294:innervation / Q000502:physiology; D014628:Vagotomy; D014630:Vagus Nerve / Q000502:physiology