Impact of vagus nerve integrity testing on surgical management in patients with previous operations with potential risk of vagal injury
Background Thoracic and foregut operations can cause vagal nerve injury resulting in delayed gastric emptying or gastroparesis. However, the cause of gastroparesis in these patients is not always from a vagal injury. We hypothesize that vagal nerve integrity (VNI) testing may better define who has v...
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| Veröffentlicht in: | Surgical endoscopy 2019-08, Vol.33 (8), p.2620-2628 |
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| creator | Yolsuriyanwong, Kamthorn Marcotte, Eric Venu, Mukund Chand, Bipan |
| description | Background
Thoracic and foregut operations can cause vagal nerve injury resulting in delayed gastric emptying or gastroparesis. However, the cause of gastroparesis in these patients is not always from a vagal injury. We hypothesize that vagal nerve integrity (VNI) testing may better define who has vagal nerve dysfunction. This information may change subsequent operations. The aim of this study was to evaluate the impact of VNI testing in patients with prior thoracic or gastric surgery.
Methods
From January 2014 to December 2017, patients who had previous operations with the potential risk of vagal injury and had VNI testing were reviewed. Excluded patients were those with no plan for a second operation or the second operation was only for gastroparesis. The main outcome was the percentage of operations altered due to the results of VNI testing.
Results
Twelve patients (eight females) were included. Ages ranged from 37 to 77 years. VNI results were compatible with vagal injury in eight patients (67%). VNI test results altered subsequent operative plans in 41.7% (5/12). Pyloroplasty was done in addition to fundoplication in two patients. Plans for hiatal hernia repair with or without redo-fundoplication in three patients were changed by an additional pyloroplasty in one patient and partial gastrectomy with Roux-en-Y reconstruction in two patients. All patients who had secondary surgery had resolution of symptoms and improvement in objective testing.
Conclusion
The addition of VNI testing in patients with a previous potential risk of vagal nerve injury may help the surgeon select the appropriate secondary operation. |
| doi_str_mv | 10.1007/s00464-018-6562-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2126902240</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2126902240</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-1f5589d89d457c12feb24956f97a27e1d2ed1bef082adecff205379e009fb3bb3</originalsourceid><addsrcrecordid>eNp1kcGKFDEQhoMo7rj6AF4k4MVLayXd6UyOsqy6sOBFzyHdXWkzTqfbJD0yT-BrW8PMKghCICn-r_6q8DP2UsBbAaDfZYCmbSoQ26pVrazMI7YRTS0rKcX2MduAqaGS2jRX7FnOOyDcCPWUXdVQt8Jo2LBfd9Pi-sJnzw9uXDOPmA7IQyw4plCOvGAuIY58jjyvaQy92_PJRTfihLEQyBdXAj0z_xnKN74kPISZjOYFEylzfBDmQlSg9hTy98tAqkLcren4nD3xbp_xxeW-Zl8_3H65-VTdf_54d_P-vuprLUslvFJbM9BplO6F9NjJxqjWG-2kRjFIHESHHrbSDdh7L0HV2iCA8V3ddfU1e3P2XdL8Y6W_2SnkHvd7F5G2tlLI1oCUDRD6-h90N68p0nYnSgmhtNJEiTPVpznnhN4uKUwuHa0Ae0rJnlOylJI9pWQN9by6OK_dhMOfjodYCJBnIJMUR0x_R__f9TeDLJ_t</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2125115757</pqid></control><display><type>article</type><title>Impact of vagus nerve integrity testing on surgical management in patients with previous operations with potential risk of vagal injury</title><source>MEDLINE</source><source>SpringerNature Complete Journals</source><creator>Yolsuriyanwong, Kamthorn ; Marcotte, Eric ; Venu, Mukund ; Chand, Bipan</creator><creatorcontrib>Yolsuriyanwong, Kamthorn ; Marcotte, Eric ; Venu, Mukund ; Chand, Bipan</creatorcontrib><description>Background
Thoracic and foregut operations can cause vagal nerve injury resulting in delayed gastric emptying or gastroparesis. However, the cause of gastroparesis in these patients is not always from a vagal injury. We hypothesize that vagal nerve integrity (VNI) testing may better define who has vagal nerve dysfunction. This information may change subsequent operations. The aim of this study was to evaluate the impact of VNI testing in patients with prior thoracic or gastric surgery.
Methods
From January 2014 to December 2017, patients who had previous operations with the potential risk of vagal injury and had VNI testing were reviewed. Excluded patients were those with no plan for a second operation or the second operation was only for gastroparesis. The main outcome was the percentage of operations altered due to the results of VNI testing.
Results
Twelve patients (eight females) were included. Ages ranged from 37 to 77 years. VNI results were compatible with vagal injury in eight patients (67%). VNI test results altered subsequent operative plans in 41.7% (5/12). Pyloroplasty was done in addition to fundoplication in two patients. Plans for hiatal hernia repair with or without redo-fundoplication in three patients were changed by an additional pyloroplasty in one patient and partial gastrectomy with Roux-en-Y reconstruction in two patients. All patients who had secondary surgery had resolution of symptoms and improvement in objective testing.
Conclusion
The addition of VNI testing in patients with a previous potential risk of vagal nerve injury may help the surgeon select the appropriate secondary operation.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6562-9</identifier><identifier>PMID: 30361970</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Female ; Fundoplication ; Gastroenterology ; Gastrointestinal surgery ; Gastroparesis - diagnosis ; Gastroparesis - etiology ; Gastroparesis - surgery ; Gynecology ; Hepatology ; Hernias ; Herniorrhaphy ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Proctology ; Retrospective Studies ; Risk ; Surgery ; Thoracic Surgical Procedures ; Vagus Nerve Injuries - diagnosis ; Vagus Nerve Injuries - etiology ; Vagus Nerve Injuries - surgery</subject><ispartof>Surgical endoscopy, 2019-08, Vol.33 (8), p.2620-2628</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-1f5589d89d457c12feb24956f97a27e1d2ed1bef082adecff205379e009fb3bb3</citedby><cites>FETCH-LOGICAL-c372t-1f5589d89d457c12feb24956f97a27e1d2ed1bef082adecff205379e009fb3bb3</cites><orcidid>0000-0002-5236-6798</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-018-6562-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6562-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30361970$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yolsuriyanwong, Kamthorn</creatorcontrib><creatorcontrib>Marcotte, Eric</creatorcontrib><creatorcontrib>Venu, Mukund</creatorcontrib><creatorcontrib>Chand, Bipan</creatorcontrib><title>Impact of vagus nerve integrity testing on surgical management in patients with previous operations with potential risk of vagal injury</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Thoracic and foregut operations can cause vagal nerve injury resulting in delayed gastric emptying or gastroparesis. However, the cause of gastroparesis in these patients is not always from a vagal injury. We hypothesize that vagal nerve integrity (VNI) testing may better define who has vagal nerve dysfunction. This information may change subsequent operations. The aim of this study was to evaluate the impact of VNI testing in patients with prior thoracic or gastric surgery.
Methods
From January 2014 to December 2017, patients who had previous operations with the potential risk of vagal injury and had VNI testing were reviewed. Excluded patients were those with no plan for a second operation or the second operation was only for gastroparesis. The main outcome was the percentage of operations altered due to the results of VNI testing.
Results
Twelve patients (eight females) were included. Ages ranged from 37 to 77 years. VNI results were compatible with vagal injury in eight patients (67%). VNI test results altered subsequent operative plans in 41.7% (5/12). Pyloroplasty was done in addition to fundoplication in two patients. Plans for hiatal hernia repair with or without redo-fundoplication in three patients were changed by an additional pyloroplasty in one patient and partial gastrectomy with Roux-en-Y reconstruction in two patients. All patients who had secondary surgery had resolution of symptoms and improvement in objective testing.
Conclusion
The addition of VNI testing in patients with a previous potential risk of vagal nerve injury may help the surgeon select the appropriate secondary operation.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Fundoplication</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gastroparesis - diagnosis</subject><subject>Gastroparesis - etiology</subject><subject>Gastroparesis - surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hernias</subject><subject>Herniorrhaphy</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Surgery</subject><subject>Thoracic Surgical Procedures</subject><subject>Vagus Nerve Injuries - diagnosis</subject><subject>Vagus Nerve Injuries - etiology</subject><subject>Vagus Nerve Injuries - surgery</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kcGKFDEQhoMo7rj6AF4k4MVLayXd6UyOsqy6sOBFzyHdXWkzTqfbJD0yT-BrW8PMKghCICn-r_6q8DP2UsBbAaDfZYCmbSoQ26pVrazMI7YRTS0rKcX2MduAqaGS2jRX7FnOOyDcCPWUXdVQt8Jo2LBfd9Pi-sJnzw9uXDOPmA7IQyw4plCOvGAuIY58jjyvaQy92_PJRTfihLEQyBdXAj0z_xnKN74kPISZjOYFEylzfBDmQlSg9hTy98tAqkLcren4nD3xbp_xxeW-Zl8_3H65-VTdf_54d_P-vuprLUslvFJbM9BplO6F9NjJxqjWG-2kRjFIHESHHrbSDdh7L0HV2iCA8V3ddfU1e3P2XdL8Y6W_2SnkHvd7F5G2tlLI1oCUDRD6-h90N68p0nYnSgmhtNJEiTPVpznnhN4uKUwuHa0Ae0rJnlOylJI9pWQN9by6OK_dhMOfjodYCJBnIJMUR0x_R__f9TeDLJ_t</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Yolsuriyanwong, Kamthorn</creator><creator>Marcotte, Eric</creator><creator>Venu, Mukund</creator><creator>Chand, Bipan</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5236-6798</orcidid></search><sort><creationdate>20190801</creationdate><title>Impact of vagus nerve integrity testing on surgical management in patients with previous operations with potential risk of vagal injury</title><author>Yolsuriyanwong, Kamthorn ; Marcotte, Eric ; Venu, Mukund ; Chand, Bipan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-1f5589d89d457c12feb24956f97a27e1d2ed1bef082adecff205379e009fb3bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Fundoplication</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gastroparesis - diagnosis</topic><topic>Gastroparesis - etiology</topic><topic>Gastroparesis - surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hernias</topic><topic>Herniorrhaphy</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Surgery</topic><topic>Thoracic Surgical Procedures</topic><topic>Vagus Nerve Injuries - diagnosis</topic><topic>Vagus Nerve Injuries - etiology</topic><topic>Vagus Nerve Injuries - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yolsuriyanwong, Kamthorn</creatorcontrib><creatorcontrib>Marcotte, Eric</creatorcontrib><creatorcontrib>Venu, Mukund</creatorcontrib><creatorcontrib>Chand, Bipan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yolsuriyanwong, Kamthorn</au><au>Marcotte, Eric</au><au>Venu, Mukund</au><au>Chand, Bipan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of vagus nerve integrity testing on surgical management in patients with previous operations with potential risk of vagal injury</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>33</volume><issue>8</issue><spage>2620</spage><epage>2628</epage><pages>2620-2628</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Thoracic and foregut operations can cause vagal nerve injury resulting in delayed gastric emptying or gastroparesis. However, the cause of gastroparesis in these patients is not always from a vagal injury. We hypothesize that vagal nerve integrity (VNI) testing may better define who has vagal nerve dysfunction. This information may change subsequent operations. The aim of this study was to evaluate the impact of VNI testing in patients with prior thoracic or gastric surgery.
Methods
From January 2014 to December 2017, patients who had previous operations with the potential risk of vagal injury and had VNI testing were reviewed. Excluded patients were those with no plan for a second operation or the second operation was only for gastroparesis. The main outcome was the percentage of operations altered due to the results of VNI testing.
Results
Twelve patients (eight females) were included. Ages ranged from 37 to 77 years. VNI results were compatible with vagal injury in eight patients (67%). VNI test results altered subsequent operative plans in 41.7% (5/12). Pyloroplasty was done in addition to fundoplication in two patients. Plans for hiatal hernia repair with or without redo-fundoplication in three patients were changed by an additional pyloroplasty in one patient and partial gastrectomy with Roux-en-Y reconstruction in two patients. All patients who had secondary surgery had resolution of symptoms and improvement in objective testing.
Conclusion
The addition of VNI testing in patients with a previous potential risk of vagal nerve injury may help the surgeon select the appropriate secondary operation.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30361970</pmid><doi>10.1007/s00464-018-6562-9</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-5236-6798</orcidid></addata></record> |
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| source | MEDLINE; SpringerNature Complete Journals |
| subjects | Abdominal Surgery Adult Aged Female Fundoplication Gastroenterology Gastrointestinal surgery Gastroparesis - diagnosis Gastroparesis - etiology Gastroparesis - surgery Gynecology Hepatology Hernias Herniorrhaphy Humans Male Medicine Medicine & Public Health Middle Aged Postoperative Complications - diagnosis Postoperative Complications - etiology Postoperative Complications - surgery Proctology Retrospective Studies Risk Surgery Thoracic Surgical Procedures Vagus Nerve Injuries - diagnosis Vagus Nerve Injuries - etiology Vagus Nerve Injuries - surgery |
| title | Impact of vagus nerve integrity testing on surgical management in patients with previous operations with potential risk of vagal injury |
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