The influence of antibiotic and mechanical bowel preparation on the microbiome in colorectal cancer surgery: A pilot study
Lange UG, Lehr K, Thieme R, Hoffmeister A, Feisthammel J, Gockel I, Link A, Jansen-Winkeln B (2025)
Publication Type: Journal article
Publication year: 2025
Journal
Book Volume: 22
Article Number: 100302
DOI: 10.1016/j.sipas.2025.100302
Abstract
Backround: The extent to which bowel preparation mechanical (MBP) or oral antibiotic (OA) or in combination (MBP/OA)) should be performed prior to elective colorectal surgery is the subject of ongoing debate. The aim of our study was to investigate the effect of MPB/OA [with single-shot intravenous antibiotic administration before incision (MPB/OA+ivAB)] on the microbiome of patients with colorectal carcinoma (CRC) operated minimally-invasive. Methods: We were studying 16 consecutive patients who underwent elective resection surgery for CRC at our centre in a prospective panel study. MBP was performed and 1 g parmomomycin/500 mg metronidazole was administered orally one day preoperatively; 1 g ertapenem was administered intravenously 30 min prior incision. Three mucosal samples were taken preoperatively during colonoscopy and intraoperatively and analysed by 16S rRNA V1-V2 gene sequencing. Results: Before MPB/OA+ivOA, the genera Phocaeicola (10 %), Bacteroides (7 %) and unclassified Ruminococcaceae (6 %) were predominant. After preparation, all bacteria were reduced except Enterococcus (7 %) and Escherichia/Shigella (6 %), which had increased. Significant reductions were seen for Bacteroides (p = 0.01), Haemophilus (p = 0.047), Holdemanella (p = 0.004), Neisseria (p = 0.004), Odoribacter (p = 0.027), unclassified Clostridiales (p = 0.008) and unclassified Ruminococcacaeae (p = 0.009). Large effect sizes (Cohens'd) were seen for Bacteroidetes (d = 0.864) and unclassified Ruminococcacaeae (d = 0.909). Conclusions: In our pilot study, we observed a significant reduction in seven bacterial genera after MBP/OA+ivAB in patients with CRC. Some of these bacterial genera have been associated with anastomotic insufficiency. Further, large in-depth analyses are needed to evaluate perioperative microbial drift with postoperative complications.
Involved external institutions
Otto-von-Guericke-Universität Magdeburg
Germany (DE)
Universitätsklinikum Leipzig
Germany (DE)
Universität Leipzig
Germany (DE)
Klinikum St. Georg
Germany (DE)
Germany (DE)
Universitätsklinikum Leipzig
Germany (DE)
Universität Leipzig
Germany (DE)
Klinikum St. Georg
Germany (DE)
How to cite
APA:
Lange, U.G., Lehr, K., Thieme, R., Hoffmeister, A., Feisthammel, J., Gockel, I.,... Jansen-Winkeln, B. (2025). The influence of antibiotic and mechanical bowel preparation on the microbiome in colorectal cancer surgery: A pilot study. Surgery in Practice and Science, 22. https://doi.org/10.1016/j.sipas.2025.100302
MLA:
Lange, Undine Gabriele, et al. "The influence of antibiotic and mechanical bowel preparation on the microbiome in colorectal cancer surgery: A pilot study." Surgery in Practice and Science 22 (2025).
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