[Clinical study on the feasibility of preserving vagal trunks in the surgical treatment of carcinoma of the thoracic esophagus].

The results of preserving vagal trunks in the surgical treatment of 47 patients with the carcinoma of the thoracic esophagus were discussed through a controlled study. There were 20 patients in the test group with vagus nerve being preserved (PG) and 27 in the control group (CG) with vagus nerve being routinely severed. Eighteen patients in PG and 26 in CG underwent radical resections, the remaining patients received palliative surgery. Pathological findings showed that 3 cases (15.0%) in PG and 3 cases (11.1%) in CG had cancerous invasion near the vagal trunks and/or their main branchs close to the primary cancer; and 1 case (5.0%) in PG and 3 (11.1%) in CG the vagal nerves were actually invaded by cancer cells. Determinations of basal gastric acid output (BAO) and half gastric emptying time (T 1/2) revealed that the mean value of BAO (1.93mmol/h) and T 1/2(63.51min.) of the PG were statistically different from those of 0.75mmol/h and > 105min. in CG, but similar to those of the healthy group and the preoperative control values. We consider that it is feasible to preserve vagal trunks in the operation and is beneficial in minimizing of postoperative disturbances of gastric acid output and gastric motility; but the indications of this procedure should only be limited to T1-T2 lesions in order not to jeopardize the radicality of tumor resection.