title: 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.
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).
  
  
  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.
authors.affiliation: Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Tlalpan, Mexico. herreram@quetzal.innsz.mx
authors.forename: Miguel F
authors.initials: MF
authors.lastname: Herrera
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Pantoja
authors.forename: David
authors.initials: D
authors.lastname: Velázquez-Fernández
authors.forename: Javier
authors.initials: J
authors.lastname: Cabiedes
authors.forename: Carlos
authors.initials: C
authors.lastname: Aguilar-Salinas
authors.forename: Eduardo
authors.initials: E
authors.lastname: García-García
authors.forename: Alfredo
authors.initials: A
authors.lastname: Rivas
authors.forename: Christian
authors.initials: C
authors.lastname: Villeda
authors.forename: Diego F
authors.initials: DF
authors.lastname: Hernández-Ramírez
authors.forename: Andrea
authors.initials: A
authors.lastname: Dávila
authors.forename: Aarón
authors.initials: A
authors.lastname: Zaraín
mesh_terms: 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
chemical_list: 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