Abstract
We investigated microbiota changes following surgical colon cancer resection and evaluate effects of probiotics on microbiota and surgical recovery. This randomized double-blind trial was performed at four medical centers in South Korea. Of 68 patients expected to undergo anterior sigmoid colon cancer resection, 60 were eligible, of whom 29 and 31 received probiotics and placebo, respectively, for four weeks, starting at one week preoperatively. Third- and/or fourth-week information on anterior resection syndrome (ARS), inflammatory markers, and quality of life was obtained. Stool sample analysis was conducted after randomization and bowel preparation and at three and four postoperative weeks. Bacteria were categorized into Set I (with probiotic effects) and II (colon cancer-associated). The probiotic group’s ARS score showed an improving trend (p = 0.063), particularly for flatus control (p = 0.030). Serum zonulin levels significantly decreased with probiotics. Probiotic ingestion resulted in compositional changes in gut microbiota; greater increases and decreases in Set I and II bacteria, respectively, occurred with probiotics. Compositional increase in Set I bacteria was associated with reduced white blood cells, neutrophils, neutrophil-lymphocyte ratio, and zonulin. Bifidobacterium composition was negatively correlated with zonulin levels in the probiotic group. Probiotics improved postoperative flatus control and modified postoperative changes in microbiota and inflammatory markers.
Highlights
Bowel dysfunction with symptoms similar to irritable bowel syndrome (IBS) or functional bowel disorder may occur after colon resection [1]
An association may exist between gut microbiota and various colorectal diseases, including colon cancer, inflammatory bowel disease (IBD), and IBS [2,3]
We evaluated changes in microbiota composition and inflammatory markers associated with surgical resection for colon cancer and investigated the impact of probiotics on postoperative bowel dysfunction, microbiota composition, and inflammatory markers during surgical treatment for colon cancer
Summary
Bowel dysfunction with symptoms similar to irritable bowel syndrome (IBS) or functional bowel disorder may occur after colon resection [1]. Probiotics may influence the extent of postoperative bowel dysfunction by altering the gut microbiota composition. There are insufficient studies on serial gut microbiome changes after surgically resecting colon cancer [4]. An association may exist between gut microbiota and various colorectal diseases, including colon cancer, inflammatory bowel disease (IBD), and IBS [2,3]. Mechanical bowel preparation, and antibiotics, which are all aspects of cancer treatment, are associated with compositional changes in gut microbiota [6,7]. Colon cancer is associated with changes in gut microbiota composition. Observing changes in the microbiota before and after surgery in bowel cancer cases can be useful to explore their contribution to recovery
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