Kamoga Ronald1, Nakidde Gladys2, Kintu Mugagga3, Grace Muwanga3, Amadi O Ihunwo4. 1. Department of Human Anatomy, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara city, Uganda. rkamoga@must.ac.ug. 2. Departments of Nursing, Bishop Stuart University, P. O. Box 09, Mbarara city, Uganda. 3. Department of Human Anatomy, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara city, Uganda. 4. School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Abstract
PURPOSE: Vagus nerve injuries during gastroesophageal surgery may cause significant symptoms due to loss of vagal anti-inflammatory and neuromodulator function. Many previous studies have shown high anatomical variability of the vagus nerve at the esophageal hiatus, but information on its variability in Uganda specifically and Africa in general is scanty. This study provides a reliable and detailed description of the anatomical variation and distribution of the vagus nerve in the esophageal hiatus region of post-mortem cases in Uganda. METHODS: This was an analytical cross-sectional survey of 67 unclaimed post-mortem cases. Data collection used a pretested data collection form. Data were entered into Epi-Info version 6.0 data base then exported into STATA software 13.0 for analysis. RESULTS: The pattern of the anterior vagal trunk structures at the esophageal hiatus was: single trunk [65.7%]; biplexus [20.9%]; triplexus [8.9%] and double-but-not-connected trunks [4.5%]. The pattern of the posterior trunk structures were: single trunk [85.1%]; biplexus 10.4% and triplexus [4.5%]. There was no statistically significant gender difference in the pattern of vagal fibres. There was no major differences in the pattern from comparable British studies. CONCLUSION: The study confirmed high variability in the distribution of the vagus nerve at the esophageal hiatus, unrelated to gender differences. Surgeons must consider and identify variants of vagal innervation when carrying out surgery at the gastroesophageal junction to avoid accidental vagal injuries. Published surgical techniques for preserving vagal function are valid in Uganda.
PURPOSE: Vagus nerve injuries during gastroesophageal surgery may cause significant symptoms due to loss of vagal anti-inflammatory and neuromodulator function. Many previous studies have shown high anatomical variability of the vagus nerve at the esophageal hiatus, but information on its variability in Uganda specifically and Africa in general is scanty. This study provides a reliable and detailed description of the anatomical variation and distribution of the vagus nerve in the esophageal hiatus region of post-mortem cases in Uganda. METHODS: This was an analytical cross-sectional survey of 67 unclaimed post-mortem cases. Data collection used a pretested data collection form. Data were entered into Epi-Info version 6.0 data base then exported into STATA software 13.0 for analysis. RESULTS: The pattern of the anterior vagal trunk structures at the esophageal hiatus was: single trunk [65.7%]; biplexus [20.9%]; triplexus [8.9%] and double-but-not-connected trunks [4.5%]. The pattern of the posterior trunk structures were: single trunk [85.1%]; biplexus 10.4% and triplexus [4.5%]. There was no statistically significant gender difference in the pattern of vagal fibres. There was no major differences in the pattern from comparable British studies. CONCLUSION: The study confirmed high variability in the distribution of the vagus nerve at the esophageal hiatus, unrelated to gender differences. Surgeons must consider and identify variants of vagal innervation when carrying out surgery at the gastroesophageal junction to avoid accidental vagal injuries. Published surgical techniques for preserving vagal function are valid in Uganda.
Authors: Liping Zhou; Adrian Filiberti; Mary Beth Humphrey; Christian D Fleming; Benjamin J Scherlag; Sunny S Po; Stavros Stavrakis Journal: Exp Physiol Date: 2018-11-29 Impact factor: 2.969
Authors: S van Rijn; N F Rinsma; M Y A van Herwaarden-Lindeboom; J Ringers; H G Gooszen; P J J van Rijn; R A Veenendaal; J M Conchillo; N D Bouvy; Adrian A M Masclee Journal: Am J Gastroenterol Date: 2016-03-15 Impact factor: 10.864
Authors: Cathy Cailotto; Pedro J Gomez-Pinilla; Léa M Costes; Jan van der Vliet; Martina Di Giovangiulio; Andrea Némethova; Gianluca Matteoli; Guy E Boeckxstaens Journal: PLoS One Date: 2014-01-29 Impact factor: 3.240