title: Effect of Vagus Nerve Injury on the Outcome of Antireflux Surgery: An Extensive Literature Review.
abstract: BACKGROUND
  Vagus nerve injury (VNI) is a feared complication of antireflux surgery (ARS). The impact of VNI on the functional outcomes of ARS has not yet been evaluated systematically. The aim of this review was to evaluate the impact of VNI on functional and clinical outcome of ARS.
  
  
  METHODS
  A systematic search was performed until March 2015, using the following online databases: MEDLINE, Embase and the Cochrane Register of Controlled Clinical Trials. Eight studies remained available for assessment. Articles were divided into 2 groups: (a) one with unintended, accidental VNI and (b) one group comparing ARS with and without intended vagotomy.
  
  
  RESULTS
  The prevalence of unintended, accidental VNI ranged from 10 to 42% after ARS. No clear differences were seen in outcome for reflux control between the VNI and vagus nerve intact group. A higher prevalence of diarrhea, nausea and vomiting was observed in the VNI group.
  
  
  CONCLUSIONS
  VNI is a feared but neglected complication of ARS. Larger prospective studies that objectively assess vagus nerve integrity before and after ARS are needed.
authors.affiliation: Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Selwyn
authors.initials: S
authors.lastname: van Rijn
authors.forename: Yvonne G M
authors.initials: YG
authors.lastname: Roebroek
authors.forename: Jose M
authors.initials: JM
authors.lastname: Conchillo
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Bouvy
authors.forename: Adrian A M
authors.initials: AA
authors.lastname: Masclee
mesh_terms: D003967:Diarrhea / Q000209:etiology; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D009325:Nausea / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D015995:Prevalence; D016896:Treatment Outcome; D014628:Vagotomy / Q000009:adverse effects*; D061223:Vagus Nerve Injuries / Q000150:complications* / Q000453:epidemiology*; D014839:Vomiting / Q000209:etiology