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.
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).


METHODS
Twenty-two patients were randomized into two groups, LRYGB alone or with omentectomy. Levels of interleukin-6, C-reactive protein, tumor necrosis factor-alpha, 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.
Herrera
Miguel F
MF
Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Tlalpan, Mexico. herreram@quetzal.innsz.mx
Pantoja
Juan Pablo
JP
Velázquez-Fernández
David
D
Cabiedes
Javier
J
Aguilar-Salinas
Carlos
C
García-García
Eduardo
E
Rivas
Alfredo
A
Villeda
Christian
C
Hernández-Ramírez
Diego F
DF
Dávila
Andrea
A
Zaraín
Aarón
A
D000209:Acute-Phase Proteins / Q000378:metabolism*; D052242:Adiponectin / Q000097:blood; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D015850:Interleukin-6 / Q000097:blood; D050152:Intra-Abdominal Fat / Q000601:surgery; D010535:Laparoscopy; D020738:Leptin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000276:immunology / Q000378:metabolism / Q000601:surgery*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000276:immunology / Q000378:metabolism / Q000601:surgery*; D009852:Omentum / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D015431:Weight Loss
C499918:ADIPOQ protein, human; D000209:Acute-Phase Proteins; D052242:Adiponectin; D001786:Blood Glucose; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D020738:Leptin; D008055:Lipids; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein