Omentectomy for Metabolic Syndrome in Gastric Cancer Patients

The Effect of Visceral Fat Removal for Gastric Cancer Patients With Metabolic Syndrome, Randomized Pilot Study: Omentectomy for Metabolic Syndrome (OMS)

Many features of the metabolic syndrome are associated with insulin resistance. And, metabolic syndrome and insulin resistance are related to visceral obesity. Therefore, the investigators hypothesized that visceral fat removal (omentectomy) can make favorable results for the insulin resistance and metabolic syndrome. As the omentectomy is optional procedure during a surgery for early gastric cancer, the investigators will divide patients randomly into two groups, total omentectomy group and omentum preserving group.

The investigators will compare the change of insulin resistance (HOMA-IR) and improvement of metabolic syndrome between total omentectomy and omentum preserving group.

Inclusion Criteria:

• Histologically confirmed adenocarcinoma in stomach
• Aged≥20 years and ≤80 years
• Scheduled as laparoscopic distal gastrectomy (cT1N0M0 or cT2N0M0)
• Metabolic syndrome (NCEP:ATP III (National Cholesterol Education Program and Adult Treatment Panel III) -harmonizing definition criteria
• ECOG 0 (Eastern Cooperative Oncology Group)
• ASA score class I-III (American Society of Anesthesiologists)
• patient has given their written informed consent to participate in the study

Exclusion Criteria:

• Simultaneously combined resection of other organ
• Active other malignancy
• Expected to severe intra-abdominal adhesion due to previous abdominal operation history
• Uncontrolled co-morbidity
• Vulnerable patients