Key result
Preserving the thoracic and cardiac branches of the vagus nerve during minimally invasive lobectomy significantly reduced heart rate at discharge compared to traditional surgery (75.3 bpm vs. 86.0 bpm, P=0.038).
Why the study?
Does vagal nerve protection reduce postoperative heart rate in patients undergoing minimally invasive lobectomy?
RCT (n=40)
Randomly divided
No
Does vagal nerve protection reduce postoperative heart rate in patients undergoing minimally invasive lobectomy?
Preserving the thoracic and cardiac branches of the vagus nerve during lobectomy helps maintain pre-surgical heart rate and prevents postoperative tachycardia.
Vagal preservation was associated with lower discharge heart rates; hypothesis-generating and should not yet change practice.
OBJECTIVES: As a common malignant tumor worldwide, lung cancer receives substantial attention from specialists. Surgery occupies an important position in lung cancer treatment, particularly early treatment. To better improve quality of life for patients after surgery, we report our surgical approach to protect vagal nerve branches during lung cancer surgery, especially the thoracic branch, which is important to maintain a suitable heart rate after surgery.METHODS: We selected 40 patients who underwent lobectomy and systematic dissection of mediastinal lymph nodes during the same period. Patients were divided into two groups: the control group (traditional surgery) and the experimental group (surgery with vagal nerve/vagal branch protection). During surgery, vagal nerve function was preserved as much as possible.RESULTS: There were no significant differences in operation time, intraoperative bleeding, postoperative pain, and discharge time between the two groups. Heart rate at discharge was significantly reduced in the experimental group compared with the control group (75.30 bpm vs. 86.00 bpm, respectively; P = 0.038). Heart rate at discharge was compared with heart rate at admission in both groups. The change in heart rate after surgery compared with heart rate at admission was less marked in the experimental group compared with the control group.CONCLUSIONS: Preserving the thoracic and cardiac branches of the vagus nerve during surgery can effectively reduce heart rate in patients after surgery and maintain pre-surgical heart rate.
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Liu et al. (2021) conducted an RCT in Lung cancer (n=40). Vagal nerve protection during lobectomy vs. Traditional surgery (routine systemic lymph node dissection) was evaluated on Heart rate at discharge (p=0.038). Preserving the thoracic and cardiac branches of the vagus nerve during minimally invasive lobectomy significantly reduced heart rate at discharge compared to traditional surgery (75.3 bpm vs. 86.0 bpm, P=0.038).
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