吻合口瘘（AL）是结直肠癌（CRC）切除术后可能危及生命的并发症。在这项研究中，我们的目的是揭示手术前、手术中和手术后微生物结构的纵向变化，并确定微生物的改变是否可以预测吻合口充分愈合 (AS) 和术前 AL 之间的风险评估。我们通过 16S rRNA V1-V2 基因测序分析了 134 份结肠粘膜活检样本的微生物群。在手术前、手术中和手术后从三个地点采集样本，患者在初次采集后和手术期间接受抗生素治疗。微生物结构在不同时间点表现出与手术相关的动态变化。随着时间的推移，细菌的总体多样性和一些属（如粪杆菌属或阿里氏菌属）的丰度下降，而肠球菌属和大肠杆菌属则增加。 AS 和 AL 之间的类群分布揭示了普氏菌属、粪杆菌属和 Phocaeicola 等属的丰度存在显着差异。除了 Phocaeicola 之外，瘤胃球菌 2 和 Blautia 在术前样本类型之间的丰度也存在显着差异。这些属对 AL 的预测价值的 ROC 分析显示 AUC 为 0.802 (p = 0.0013)。总之，微生物组成与术后结果相关，某些菌属的丰度可能可以预测术后并发症。© 2024。作者。

Anastomotic leakage (AL) is a potentially life-threatening complication following colorectal cancer (CRC) resection. In this study, we aimed to unravel longitudinal changes in microbial structure before, during, and after surgery and to determine if microbial alterations may be predictive for risk assessment between sufficient anastomotic healing (AS) and AL prior surgery. We analysed the microbiota of 134 colon mucosal biopsies with 16S rRNA V1-V2 gene sequencing. Samples were collected from three location sites before, during, and after surgery, and patients received antibiotics after the initial collection and during surgery. The microbial structure showed dynamic surgery-related changes at different time points. Overall bacterial diversity and the abundance of some genera such as Faecalibacterium or Alistipes decreased over time, while the genera Enterococcus and Escherichia_Shigella increased. The distribution of taxa between AS and AL revealed significant differences in the abundance of genera such as Prevotella, Faecalibacterium and Phocaeicola. In addition to Phocaeicola, Ruminococcus2 and Blautia showed significant differences in abundance between preoperative sample types. ROC analysis of the predictive value of these genera for AL revealed an AUC of 0.802 (p = 0.0013). In summary, microbial composition was associated with postoperative outcomes, and the abundance of certain genera may be predictive of postoperative complications.© 2024. The Author(s).