title: A prospective randomized controlled trial assessing the efficacy of omentopexy during laparoscopic sleeve gastrectomy in reducing postoperative gastrointestinal symptoms.
abstract: BACKGROUND
  Patients undergoing sleeve gastrectomy experience a significant amount of postoperative gastrointestinal (GI) symptoms. The purpose of our study was to assess the efficacy of omentopexy during laparoscopic sleeve gastrectomy (LSG) in reducing postoperative food intolerance and GI symptoms.
  
  
  METHODS
  Morbidly obese patients undergoing LSG were randomly assigned to have LSG with or without omentopexy from May 2012 to June 2013. A total of 60 patients were recruited with 30 patients in each group. Patients and the symptom scorer were blinded as to the assigned surgery. All procedures were performed by one of two surgeons utilizing the same surgical technique. Patients were administered standardized surveys, including the Rhodes Index survey, gastroesophageal reflux disease (GERD) impact survey, and Eating Assessment Tool (EAT) survey at various time points postoperatively to assess nausea, vomiting, retching, frequency of GI symptoms, and level of distress.
  
  
  RESULTS
  There was no significant difference in patient age, percent decrease in BMI at any time point, or length of hospitalization between the two groups (P > 0.05). Furthermore, there was no significant difference in Rhodes Index scores, GERD impact scores, or EAT scores at any time point (P > 0.05). Patients in the LSG with omentopexy group required significantly more ondansetron perioperatively (16.1 ± 12.9 mg vs. 10.3 ± 10.2 mg, respectively; P = 0.04); however, there was no difference in metoclopramide requirement (P = 0.22). Surgical morbidity was not significantly different between the two groups (P > 0.05). Finally, there was no significant difference in number of postoperative clinic visits, office telephone encounters, total postoperative readmissions, or postoperative readmissions associated with GI symptoms (P > 0.05).
  
  
  CONCLUSIONS
  Omentopexy did not significantly decrease postoperative food intolerance or GI symptoms in morbidly obese patients undergoing LSG. Other methods of mitigating postoperative intolerance to oral intake and GI symptoms should be investigated.
authors: Department of Surgery, New York-Presbyterian Hospital/Weill Cornell Medical College, 525 East 68th Street, Box 207, New York, NY, 10065, USA, cafaneh@gmail.com.
authors: Cheguevara
authors: C
authors: Afaneh
authors: Ricardo
authors: R
authors: Costa
authors: Alfons
authors: A
authors: Pomp
authors: Gregory
authors: G
authors: Dakin
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D009852:Omentum / Q000601:surgery*; D017294:Ondansetron / Q000008:administration & dosage; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000932:Antiemetics; D017294:Ondansetron