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Laparoscopic Surgery Improves Blood Glucose Homeostasis and Insulin Resistance Following Distal Gastrectomy for Cancer
Author(s) -
Kanno Hitoshi,
Kiyama Teruo,
Fujita Itsuo,
Tani Aya,
Kato Shunji,
Tajiri Takashi,
Barbul Adrian
Publication year - 2009
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607109333003
Subject(s) - insulin resistance , laparoscopy , medicine , insulin , homeostasis , glucose homeostasis , gastroenterology , gastrectomy , homeostatic model assessment , surgery , cancer , endocrinology
Background : Prevention of blood glucose elevation and insulin resistance could be more pronounced in patients undergoing laparoscopic rather than open gastrectomy. Methods : Fifty‐seven patients underwent distal gastrectomy by either laparoscopy (n = 36) or an open approach (n = 21). Blood glucose, serum insulin, and the daily insulin secretion rate (urinary C‐peptide) were measured. Insulin resistance was evaluated using an adapted homeostasis model assessment of insulin resistance (HOMA‐R). Results : Blood glucose levels were lower in the laparoscopy group than in the open group on the operative day and on postoperative days (POD) 1 and 3 ( P < .001, P = .001, and P = .024, respectively). Serum insulin levels were lower in the laparoscopy group than in the open group on POD 1 and 3 ( P = .045 and P = .027, respectively). HOMA‐R was lower in the laparoscopy group than in the open group on POD 1 and 3 ( P = .024 and P = .009, respectively). Daily insulin secretion rates were lower in the laparoscopy group than in the open group on POD 1 ( P = .023). Conclusions : Laparoscopic surgery prevents blood glucose elevation and improves insulin resistance compared with open surgery.