Potential Additional Effect of Omentectomy on Metabolic Syndrome, Acute-Phase Reactants, and Inflammatory Mediators in Grade III Obese Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass
A randomized trial
- Miguel F. Herrera, MD, PHD1,
- Juan Pablo Pantoja, MD1,
- David Velázquez-Fernández, MD, PHD2,
- Javier Cabiedes, PHD3,
- Carlos Aguilar-Salinas, MD4,
- Eduardo García-García, MD5,
- Alfredo Rivas, MD6,
- Christian Villeda, MD1,
- Diego F. Hernández-Ramírez, MSC2,
- Andrea Dávila, MD6 and
- Aarón Zaraín, MD1
- 1Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Tlalpan, Mexico;
- 2Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Tlalpan, Mexico;
- 3Hap Map Laboratory, Instituto Nacional de Medicina Genómica, Mexico City, Mexico;
- 4Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Tlalpan, Mexico;
- 5The Obesity Clinic, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Tlalpan, Mexico;
- 6The School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico.
- Corresponding author: Miguel F. Herrera, herreram{at}quetzal.innsz.mx.
Abstract
OBJECTIVE To assess the additional effect of sudden visceral fat reduction by omentectomy on metabolic syndrome, acute-phase reactants, and inflammatory mediators in patients with grade III obesity (G-III O) undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB).
RESEARCH DESIGN AND METHODS Twenty-two patients were randomized into two groups, LRYGB alone or with omentectomy. Levels of interleukin-6, C-reactive protein, tumor necrosis factor-α, leptin, adiponectin, glucose, total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides, as well as clinical characteristics, were evaluated before surgery and at 1, 3, 6, and 12 months after surgery. Results were compared between groups.
RESULTS Baseline characteristics were comparable in both groups. Mean operative time was significantly higher in the group of patients who underwent omentectomy (P < 0.001). Median weight of the omentum was 795 ± 341 g. In one patient, a duodenal perforation occurred at the time of omentectomy. BMI, blood pressure, glucose, total cholesterol, LDL, and triglycerides significantly improved in both groups at 1, 3, 6, and 12 months of follow-up when compared with basal values. However, there were no consistent statistically significant differences among the groups in terms of metabolic syndrome components, acute-phase reactants, and inflammatory mediators.
CONCLUSIONS Omentectomy does not have an ancillary short-term significant impact on the components of metabolic syndrome and does not induce important changes in the inflammatory mediators in patients undergoing LRYGB. Operative time is more prolonged when omentectomy is performed.
Footnotes
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Clinical trial reg. no. NCT00923260, clinicaltrials.gov.
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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See accompanying editorial, p. 1693.
- Received October 1, 2009.
- Accepted March 1, 2010.
- © 2010 by the American Diabetes Association.
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