PERIOPERATION CHANGES COLON AND RECTUM MICROBIOCINOSIS WITH COLORECTAL PATIENTS

Abstract

Most colorectal cancer patients prove to have dysbiosis of varying severity. Perioperative period contributes to the progression of the microbiocenosis disorders. It has been proven that a large role in the development of postoperative complications is played by the state of the colon microflora.

Materials. 211 colorectal cancer patient’s (T1-4N0-2M0) colon microflora was studied by PCR. Surgeries were performed laparoscopically. In the main group, developed diagnostic algorithm was used, in which initial colon flora was studied with dysbiosis progression risk determination by developed logistic regression model and perioperative correction of revealed disorders. Standards of dysbiosis treatment were used.

Results. 100% patients in control group proved to have dysbiosis of varying severity: 1 grade - 27,4% (n=14), 2 grade - 37,3% (n=19), 3 grade - 31,4% (n=16), 4 grade - 3,9% (n=2). Dysbiosis progression was observed in postoperative period: 1 grade - 7,8% (n=4), 2 grade - 51,0% (n=26), 3 grade - 29,4% (n=15), 4 grade - 11,8% (n=6). The same preoperative results were registered in main group. However, after perioperative correction there was 12,5% (n=6) 3 grade and no registered 4 grade patients. Long-term results were better in the main group than in the control group. Adverse events were significantly higher in the control group against the main group (15,7% (n=8) and 4,2% (n=2) respectively).

Discussion. We recommend preoperative stool analysis with PCR for colon microflora determination in order to further dysbiosis correction and treatment long-term results assessment.