title: Laparoscopic surgery improves blood glucose homeostasis and insulin resistance following distal gastrectomy for cancer.
abstract: BACKGROUND
  Prevention of blood glucose elevation and insulin resistance could be more pronounced in patients undergoing laparoscopic rather than open gastrectomy.
  
  
  METHODS
  Fifty-seven patients underwent distal gastrectomy by either laparoscopy (n = 36) or an open approach (n = 21). Blood glucose, serum insulin, and the daily insulin secretion rate (urinary C-peptide) were measured. Insulin resistance was evaluated using an adapted homeostasis model assessment of insulin resistance (HOMA-R).
  
  
  RESULTS
  Blood glucose levels were lower in the laparoscopy group than in the open group on the operative day and on postoperative days (POD) 1 and 3 (P < .001, P = .001, and P = .024, respectively). Serum insulin levels were lower in the laparoscopy group than in the open group on POD 1 and 3 (P = .045 and P = .027, respectively). HOMA-R was lower in the laparoscopy group than in the open group on POD 1 and 3 (P = .024 and P = .009, respectively). Daily insulin secretion rates were lower in the laparoscopy group than in the open group on POD 1 (P = .023).
  
  
  CONCLUSIONS
  Laparoscopic surgery prevents blood glucose elevation and improves insulin resistance compared with open surgery.
authors: Department of Surgery, Nippon Medical School, Tokyo, Japan.
authors: Hitoshi
authors: H
authors: Kanno
authors: Teruo
authors: T
authors: Kiyama
authors: Itsuo
authors: I
authors: Fujita
authors: Aya
authors: A
authors: Tani
authors: Shunji
authors: S
authors: Kato
authors: Takashi
authors: T
authors: Tajiri
authors: Adrian
authors: A
authors: Barbul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D013274:Stomach Neoplasms / Q000378:metabolism / Q000601:surgery*
chemical_list: D001786:Blood Glucose; D007328:Insulin