Perioperative changes in the microbiome during rectal cancer surgery: exploratory analysis of the National Institute for Health and Care Research (NIHR) IntAct trial - Summary - MDSpire
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Perioperative changes in the microbiome during rectal cancer surgery: exploratory analysis of the National Institute for Health and Care Research (NIHR) IntAct trial
To characterize changes in the rectal microbiome in patients undergoing rectal cancer surgery and their association with postoperative outcomes, including anastomotic leak, to better understand potential interventions.
Key Findings:
Smoking status explained 3.2% of variation in beta-diversity at baseline (P = 0.046).
On the day of surgery, beta-diversity was influenced by hospital site (11.1%; P = 0.033), mechanical bowel preparation (2.6%; P = 0.024), and preoperative oral antibiotics (1.0%; P = 0.020).
Postoperatively, beta-diversity was significantly affected by hospital site (16.3%; P < 0.001), defunctioning stoma (2.9%; P = 0.003), and preoperative oral antibiotics (1.6%; P = 0.006).
Alpha-diversity decreased over time, with increases in Enterococcus and Prevotella post-surgery.
The study indicates measurable shifts in the gut microbiome during rectal cancer surgery, influenced by various treatment factors, with implications for clinical practice, although no significant differences in microbiome diversity were found between patients with and without anastomotic leak.
Limitations:
The study was limited to UK centres, which may affect generalizability to other populations.
The sample size for detecting subtle differences in microbiome composition related to clinical outcomes was small, potentially limiting the robustness of the findings.
Conclusion:
Further research is needed to explore the clinical significance of microbiome changes during rectal cancer surgery, which could help in preventing postoperative complications, particularly focusing on larger, more diverse populations.
by Jack A Helliwell, Caroline H Chilton, Caroline Young, Emma V Clark, Lyndsay Wilkinson, Alba Fuentes Balaguer, Daniel Bottomley, Julie Croft, Neil Corrigan, Andrew Kirby, Philip Quirke, Deborah D Stocken, David G Jayne, Henry M Wood
