Effects of vagus nerve preservation and vagotomy on peptide YY and body weight after subtotal gastrectomy

Kim, Hyung Hun; Park, Moo In; Lee, Sang Ho; Hwang, Hyunyong; Kim, Sung Eun; Park, Seun Ja; Moon, Won

doi:10.3748/wjg.v18.i30.4044

Cited by 15 publications

(10 citation statements)

References 33 publications

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“…Nonetheless, there is evidence of parasympathetic involvement in the control of fat mass. Clinical studies have demonstrated that surgical ablation of the abdominal vagus nerve can result in a considerable reduction of body weight ( Kral, 1979 , 1980 ; Kral et al, 1993 ; Smith et al, 1983 ), and vagal denervation has also been linked to increased weight loss following gastrectomy ( Kim et al, 2012 ; Miyato et al, 2012a , 2012b ). These data suggest that increased vagal activity may have a reciprocal role to that of the SNS, promoting a gain of fat mass.…”

Section: Introductionmentioning

confidence: 99%

A Brain-Melanocortin-Vagus Axis Mediates Adipose Tissue Expansion Independently of Energy Intake

et al. 2019

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SUMMARY The melanocortin system is a brain circuit that influences energy balance by regulating energy intake and expenditure. In addition, the brain-melanocortin system controls adipose tissue metabolism to optimize fuel mobilization and storage. Specifically, increased brain-melanocortin signaling or negative energy balance promotes lipid mobilization by increasing sympathetic nervous system input to adipose tissue. In contrast, calorie-independent mechanisms favoring energy storage are less understood. Here, we demonstrate that reduction of brain-melanocortin signaling actively promotes fat mass gain by activating the lipogenic program and adipocyte and endothelial cell proliferation in white fat depots independently of caloric intake via efferent nerve fibers conveyed by the common hepatic branch of the vagus nerve. Those vagally regulated obesogenic signals also contribute to the fat mass gain following chronic high-fat diet feeding. These data reveal a physiological mechanism whereby the brain controls energy stores that may contribute to increased susceptibility to obesity.

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Section: Introductionmentioning

confidence: 99%

A Brain-Melanocortin-Vagus Axis Mediates Adipose Tissue Expansion Independently of Energy Intake

et al. 2019

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“…[12–14] Faster gastric emptying may lead to symptoms such as fullness, bloating, nausea, and pain secondary to distention, as well as increased or earlier secretion of gastrointestinal peptides, such as cholecystokinin and glucagon-like peptide 1, in response to the increased nutrient load to the small intestine. [15] These peptides may increase symptom perception (satiety, hunger, nausea) through the activation of vagal afferents, which may partly explain the earlier satiation and increased symptoms after meals in patients with functional dyspepsia with/without increased gastric emptying.…”

Section: Discussionmentioning

confidence: 99%

“…[23] Likewise, patients who underwent vagus nerve preserved gastrectomy have shown less weight loss and shorter-term diarrhea than conventional gastrectomized groups in previous reports. [15,24,25]…”

Section: Discussionmentioning

confidence: 99%

The investigation of diet recovery after distal gastrectomy

Kim¹,

Lee²,

Bae³

et al. 2019

Medicine

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This study aims to investigate the adaptation process of the alimentary tract after distal gastrectomy and understand the impact of remnant stomach volume (RSV) on diet recovery.One year after gastrectomy, although patients’ oral intake had increased, the RSV was decreased and small bowel motility was enhanced. Patients with a larger RSV showed no additional benefits regarding nutritional outcomes.We prospectively enrolled patients who underwent distal gastrectomy with Billroth II reconstruction to treat gastric cancer at a tertiary hospital cancer center between September 2009 and February 2012. Demographic data, diet questionnaires, computed tomography (CT), and contrast fluoroscopy findings were collected. Patients were divided into 2 groups according to the RSV calculated using CT gastric volume measurements (large vs small). Dietary habits and nutritional status were compared between the groups.Seventy-eight patients were enrolled. Diet volume recovered to 90% of baseline by the 36th postoperative month, and RSV was 70% of baseline at 6 months after surgery and gradually decreased over time. One year after surgery, small bowel transit time was 75% compared to the 1st postoperative month (P < .05); however, transit time in the esophagus and remnant stomach showed no change in any studied interval. Compared to patients with a small RSV, those with a large RSV showed no differences in diet volume, habits, or other nutritional benefits (P > .05).Diet recovery for distal gastrectomy patients was achieved by increased small bowel motility. The size of the remnant stomach showed no positive impact on nutritional outcomes.

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“…In an observational study, early gastric cancer patients undergoing VPG were less likely to experience diarrhea and weight loss compared with those undergoing conventional subtotal gastrectomy. 15 Similarly, duodenal ulcer patients undergoing VPG experienced a significantly lower incidence of postoperative diarrhea compared with those who received gastrectomy with truncal vagotomy. 16 Observational studies of surgical interventions, however, are difficult to interpret due to potential lack of comparability of study groups and confounding by indication or by severity.…”

mentioning

confidence: 98%

“…Furthermore, these studies had limited sample size. 8,15,17,18 As a consequence, we conducted a randomized controlled trial to compare the postoperative QoL among early-stage gastric cancer patients with VPG vs CG.…”

mentioning

confidence: 99%

A Randomized Controlled Trial of Vagus Nerve-preserving Distal Gastrectomy Versus Conventional Distal Gastrectomy for Postoperative Quality of Life in Early Stage Gastric Cancer Patients

et al. 2016

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Effects of vagus nerve preservation and vagotomy on peptide YY and body weight after subtotal gastrectomy

Abstract: Vagus nerve preservation contributes to the maintenance of body weight after gastrectomy, and this phenomenon may be related to the suppressed activity of peptide YY(3-36).

Cited by 15 publications

References 33 publications

A Brain-Melanocortin-Vagus Axis Mediates Adipose Tissue Expansion Independently of Energy Intake

A Brain-Melanocortin-Vagus Axis Mediates Adipose Tissue Expansion Independently of Energy Intake

The investigation of diet recovery after distal gastrectomy

A Randomized Controlled Trial of Vagus Nerve-preserving Distal Gastrectomy Versus Conventional Distal Gastrectomy for Postoperative Quality of Life in Early Stage Gastric Cancer Patients

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