To investigate the clinical outcome of preservation of the vagus nerve in laparoscopic segmental gastrectomy for early gastric cancer.

The clinical data of 60 patients with early gastric cancer treated with different surgical methods from January 2016 to January 2020 were analyzed prospectively. According to the random number table, they were divided into the laparoscopic segmental gastrectomy with vagus nerve preservation group (SG group, 30 cases) and the laparoscopic partial gastrectomy group (DG group, 30 cases). Statistical analysis were performed by using SPSS 20.0 software. Perioperative related indexes such as gastric emptying function, gallbladder systolic function and quality of life were expressed as (±s) and were examined by using independent t test. The incidence of postoperative complications were analyzed by using χ² test. A P value of <0.05 was considered as statistically significant difference. Follow-up were conducted to evaluate the postoperative tumor recurrence, metastasis and survival in both two groups.

The operation time of SG group was significantly longer than that of DG group, and the first anal exhaust time was significantly shorter than that of DG group, with statistically significant difference (P<0.05). The gastric empty time of SG group was significantly shorter than those of DG group at 15, 30 and 60min after oral acetaminophen respectively (P<0.05), and the gallbladder systolic function of SG group was better than those of DG group 60min after oral acetaminophen (P<0.05). The incidence of gastroesophageal reflux and dumping syndrome 1 year after operation in SG group was significantly lower than that in DG group , with statistically significant difference (P<0.05). The postoperative quality of life in both groups increased gradually, while the postoperative quality of life of the SG group was higher than those of the DG group at 3, 6 and 12 months respectively (P<0.05). There was no statistical significance between two groups in terms of recurrence and metastasis rate of 6.7% (2/30) VS. 10.0% (3/30) during the follow-up (P>0.05). There was no death in both groups during the follow-up.

It is safe and feasible to preserve the vagus nerve during segmental gastric resection for early gastric cancer, which could achieve good clinical outcome. The patient’s gastric function recovers quickly and the quality of life after surgery improves significantly.