Commentary on a randomized controlled trial of vagus nerve- preserving distal gastrectomy in early gastric cancer

The rst randomized controlled trial (RCT) of vagal nerve- preserving distal gastrectomy (VPDG) was reported by Kim and colleagues. The study was performed in a single Korean institution (1). This RCT showed several advantages with respect to the postoperative quality of life (QoL). Patients with a diagnosis of early gastric cancer without lymph node metastasis were randomly assigned in a 1:1 ratio to VPDG or conventional distal gastrectomy (CDG). Both the hepatic branch of the anterior vagal nerve and the celiac branch of the posterior vagal nerve were preserved in the VPDG group, while both branches were resected proximally in the CDG group. QoL was assessed by a validated Korean version of the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire before gastrectomy and 3 and 12 months postoperatively. Scores of diarrhea symptoms and appetite loss were significantly lower in the VPDG group than in the CDG group 3 and 12 months postoperatively. VPDG thus reduced diarrhea and anorexia.