Basic and Translational Research, Department of Surgery, University of Minnesota, 420 Delaware Street SE, MCC 195, Minneapolis, MN, 55455, USA.
Division of Colon and Rectal Surgery, University of Minnesota, 420 Delaware Street SE, MMC 450, Minneapolis, MN, 55455, USA.
Sci Rep. 2024 Sep 17;14(1):21711. doi: 10.1038/s41598-024-72520-x.
Following bowel surgery, infectious complications, including anastomotic leak (AL), remain major sources of morbidity and mortality. Bowel preparation is often administered with the assumption that gut decontamination reduces post-surgical complications. In this study, we tested this hypothesis using a murine model of colon surgery. The mice were fed either regular chow or a high-fat, high-sugar Western diet. The day before surgery, the mice received one of four interventions: water (control), mechanical bowel preparation (MBP), oral antibiotics (OA), or both MBP and OA. We found no differences in the rates of AL among the experimental groups, and diet did not appear to affect the outcomes. Exploratory analyses showed changes in the gut microbiome consistent with the different treatments, but investigations of fecal short-chain fatty acids and RNA sequencing of colonic tissue did not reveal specific effects of the treatments or the presence of AL. However, we did identify bacterial genera that may be causally associated with AL and developed a predictive index from stool samples as a marker for the presence of AL. Future research is needed to identify and validate a microbial predictive tool and to uncover the microbial-driven mechanisms that lead to AL.
结直肠手术后，感染性并发症（包括吻合口漏）仍然是发病率和死亡率的主要原因。肠道准备通常被认为可以减少术后并发症，但这种假设尚未得到验证。本研究使用结直肠手术的小鼠模型对此进行了检验。小鼠分别给予普通饮食或高脂肪高糖的西式饮食。手术前一天，小鼠接受以下 4 种干预措施之一：水（对照）、机械肠道准备（MBP）、口服抗生素（OA）或 MBP 和 OA 联合应用。我们发现实验组之间的吻合口漏发生率没有差异，且饮食似乎也没有影响结果。探索性分析显示，不同治疗方法与肠道微生物群的变化一致，但粪便短链脂肪酸检测和结肠组织 RNA 测序均未显示出治疗的具体作用或吻合口漏的存在。然而，我们确实确定了可能与吻合口漏相关的细菌属，并从粪便样本中建立了一个预测指数作为吻合口漏的标志物。未来需要进一步研究以确定和验证微生物预测工具，并揭示导致吻合口漏的微生物驱动机制。
