TY - JOUR
T1 - Omentectomy added to Roux-en-Y gastric bypass surgery
T2 - A randomized, controlled trial
AU - Dillard, Troy H.
AU - Purnell, Jonathan Q.
AU - Smith, Mark D.
AU - Raum, William
AU - Hong, Dennis
AU - Laut, Jamie
AU - Patterson, Emma J.
N1 - Funding Information:
Support provided by a grant from the National Institutes of Health (grant R56 DK088207 to J. Q. Purnell) and the Research Advisory Committee Grant from Legacy Health Systems (Portland, OR) and also from the Oregon Clinical and Translational Research Institute (grant UL1 RR024140 from the National Center for Research Resources , a component of the National Institutes of Health, and National Institutes of Health Roadmap for Medical Research).
PY - 2013/3
Y1 - 2013/3
N2 - Background: Excess visceral adipose tissue predicts for incipient diabetes mellitus and cardiovascular disease. Human data are mixed regarding the benefits of selective visceral adipose tissue reduction. We investigated the effects of omentectomy added to laparoscopic Roux-en-Y gastric bypass on glucose homeostasis and lipids, inflammatory markers, and adipokines 90 days postoperatively in nondiabetic patients at the Legacy Good Samaritan Hospital and Oregon Health and Science University (Portland, OR). Methods: A single-blind, randomized study of laparoscopic Roux-en-Y gastric bypass plus omentectomy versus laparoscopic Roux-en-Y gastric bypass alone in 28 subjects (7 men and 21 women). The groups were matched at baseline for gender, age, and body mass index (BMI). The eligibility criteria included age ≥18 years, BMI ≥40 and <50 kg/m2 without co-morbid conditions or BMI ≥35 and <50 kg/m2 with co-morbid conditions. The primary outcome measures were changes in the fasting plasma glucose, insulin, and homostatic model assessment of insulin resistance. The secondary measures were BMI and the high-sensitivity C-reactive protein, tumor necrosis factor-α, interleukin, total and high-molecular-weight adiponectin, fibrinogen, and plasminogen activator inhibitor-1 levels. Results: After surgery, the BMI decreased significantly in both groups and was not different at the follow-up point. Although many outcome parameters improved with weight loss in both groups postoperatively, only the omentectomy group experienced statistically significant decreases in fasting glucose (P <.05), total (P =.004) and very-low-density lipoprotein (P =.001) cholesterol, and an increase in the high-molecular-weight/total adiponectin ratio (P =.013). Conclusions: Omentectomy added to laparoscopic Roux-en-Y gastric bypass results in favorable changes in glucose homeostasis, lipid levels, and adipokine profile at 90 days postoperatively. These data support the hypothesis that selective ablation of visceral adipose tissue conveys metabolic benefits in nondiabetic humans.
AB - Background: Excess visceral adipose tissue predicts for incipient diabetes mellitus and cardiovascular disease. Human data are mixed regarding the benefits of selective visceral adipose tissue reduction. We investigated the effects of omentectomy added to laparoscopic Roux-en-Y gastric bypass on glucose homeostasis and lipids, inflammatory markers, and adipokines 90 days postoperatively in nondiabetic patients at the Legacy Good Samaritan Hospital and Oregon Health and Science University (Portland, OR). Methods: A single-blind, randomized study of laparoscopic Roux-en-Y gastric bypass plus omentectomy versus laparoscopic Roux-en-Y gastric bypass alone in 28 subjects (7 men and 21 women). The groups were matched at baseline for gender, age, and body mass index (BMI). The eligibility criteria included age ≥18 years, BMI ≥40 and <50 kg/m2 without co-morbid conditions or BMI ≥35 and <50 kg/m2 with co-morbid conditions. The primary outcome measures were changes in the fasting plasma glucose, insulin, and homostatic model assessment of insulin resistance. The secondary measures were BMI and the high-sensitivity C-reactive protein, tumor necrosis factor-α, interleukin, total and high-molecular-weight adiponectin, fibrinogen, and plasminogen activator inhibitor-1 levels. Results: After surgery, the BMI decreased significantly in both groups and was not different at the follow-up point. Although many outcome parameters improved with weight loss in both groups postoperatively, only the omentectomy group experienced statistically significant decreases in fasting glucose (P <.05), total (P =.004) and very-low-density lipoprotein (P =.001) cholesterol, and an increase in the high-molecular-weight/total adiponectin ratio (P =.013). Conclusions: Omentectomy added to laparoscopic Roux-en-Y gastric bypass results in favorable changes in glucose homeostasis, lipid levels, and adipokine profile at 90 days postoperatively. These data support the hypothesis that selective ablation of visceral adipose tissue conveys metabolic benefits in nondiabetic humans.
KW - Adiponectin
KW - Bariatric surgery
KW - Gastric bypass surgery
KW - High-molecular-weight adiponectin
KW - Intra-abdominal adipose
KW - Obesity
KW - Omentectomy
KW - Omentum
KW - Roux-en-Y
KW - Visceral adipose
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U2 - 10.1016/j.soard.2011.09.027
DO - 10.1016/j.soard.2011.09.027
M3 - Article
C2 - 22118842
AN - SCOPUS:84875481838
SN - 1550-7289
VL - 9
SP - 269
EP - 275
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 2
ER -