A prospective randomized study comparing patients with morbid obesity submitted to sleeve gastrectomy with or without omentectomy.

BACKGROUND

Increased visceral adipose tissue is a risk factor for the metabolic complications associated with obesity and promotes a low-grade chronic inflammatory process. Resection of the great omentum in patients submitted to a bariatric procedure has been proposed for the amelioration of metabolic alterations and the maximization of weight loss. The aim of the present study was to investigate the impact of omentectomy performed in patients with morbid obesity undergoing sleeve gastrectomy (SG) on metabolic profile, adipokine secretion, inflammatory status, and weight loss.

METHODS

Thirty-one obese patients were randomized into two groups: SG alone or with omentectomy. Adiponectin, omentin, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), blood lipids, fasting glucose, insulin, and insulin resistance were measured before surgery and at 7 days, and 1, 3 and 12 months after surgery.

RESULTS

During the 1-year follow-up, body mass index (BMI) decreased markedly and comparably in both groups (p < 0.001). Insulin, IL-6, and hs-CRP levels decreased significantly compared to baseline (p < 0.05) in both groups with no significant difference between groups. Adiponectin and high-density lipoprotein cholesterol levels were significantly and similarly increased compared to baseline (p < 0.001) in both groups. Omentin levels increased significantly (p < 0.05) in the control group and decreased in the omentectomy group 1 year postoperatively. There was no significant change in TNF-α levels in either group.

CONCLUSIONS

The theoretical advantages of omentectomy in regard to weight loss and obesity-related abnormalities are not confirmed in this prospective study. Furthermore, omentectomy does not induce important changes in the inflammatory status in patients undergoing SG.