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Comparative Study
. 2021 Apr 1;84(4):354-360.
doi: 10.1097/JCMA.0000000000000510.

Differences in intestinal microbiota profiling after upper and lower gastrointestinal surgery

Xi-Hsuan Lin  1   2 , Ueng-Cheng Yang  3 , Jiing-Chyuan Luo  2   4   5 , Tien-En Chang  2   4 , Hung-Hsin Lin  2   6 , Chi-Wei Huang  3 , Jen-Jie Chiou  3 , Wen-Liang Fang  2   7 , Kuo-Hung Huang  2   7 , Yi-Hsiang Huang  2   4 , Ming-Chih Hou  2   4 , Fa-Yauh Lee  2   4
Affiliations
Comparative Study

Differences in intestinal microbiota profiling after upper and lower gastrointestinal surgery

Xi-Hsuan Lin et al. J Chin Med Assoc. .

Abstract

Background: We aimed to investigate the long-term effects of metabolic profiles and microbiota status in patients after upper gastrointestinal (GI) surgery and lower GI surgery and compared them with a control group.

Methods: In this cross-sectional study, we analyzed the occurrence of metabolic syndrome (MS) in 10 patients who underwent curative total gastrectomy with Roux-en-Y esophagojejunostomy (RYEJ) anastomosis, 11 patients who underwent curative partial colectomy with right hemicolectomy (RH), and 33 age- and sex-matched controls. Fecal samples were also analyzed by a next-generation sequencing method.

Results: Compared with the control group, the occurrence of MS was significantly lower among patients who underwent total gastrectomy with RYEJ than the controls over the long-term follow-up (>8 years; p < 0.05). Patients who received RH only had a trend of higher serum fasting glucose (p = 0.10). The diversity of the gut microbiota significantly decreased after RH in comparison with the control group and RYEJ group, respectively (p < 0.05). Principal component analysis revealed significant differences between the control, RYEJ, and RH groups (p < 0.001). At the genus level, the ratio of Prevotella to Bacteroides (P/B) was significantly higher in the RYEJ group than in the control group, whereas the P/B ratio was significantly lower in the RH group than in the control group (p < 0.05).

Conclusion: Early gastric cancer patients who received total gastrectomy with RYEJ had a lower occurrence of MS than the controls, while early colorectal cancer patients who received RH were associated with a higher serum fasting glucose than the controls during long-term follow-up. In parallel with the metabolic differences, the P/B ratio was also significantly altered in patients after upper and lower GI surgery.

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Conflict of interest statement

Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.

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