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Effect of preoperative immunonutrition on fecal microbiota in colon cancer patients: a secondary analysis of a randomized controlled trial

  • Soo Young Lee (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School) ;
  • Jaram Lee (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School) ;
  • Hyeong-min Park (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School) ;
  • Chang Hyun Kim (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School) ;
  • Hyeong Rok Kim (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School)
  • Received : 2022.07.08
  • Accepted : 2022.11.15
  • Published : 2023.06.01

Abstract

BACKGROUND/OBJECTIVES: This study aimed to evaluate the effect of preoperative immunonutrition on the composition of fecal microbiota following a colon cancer surgery. MATERIALS/METHODS: This study was a secondary analysis of a randomized controlled trial assessing the impact of preoperative immunonutrition on the postoperative outcomes of colon cancer surgery. Patients with primary colon cancer were enrolled and randomly assigned to receive additional preoperative immunonutrition or a normal diet alone. Oral nutritional supplementation (400 mL/day) with arginine and ω-3 fatty acids were administered to patients in the immunonutrition group for 7 days prior to surgery. Thirty-two fecal samples were collected from 16 patients in each group, and the composition of fecal microbiota was compared between the 2 groups. RESULTS: At the phylum level, no significant difference was observed in the composition of microbiota between the 2 groups (Firmicutes, 69.1% vs. 67.5%, P = 0.624; Bacteroidetes, 19.3% vs. 18.1%, P = 0.663; Actinobacteria, 6.7% vs. 10.6%, P = 0.080). The Firmicutes/Bacteroidetes ratio (4.43 ± 2.32 vs. 4.55 ± 2.51, P = 0.897) was also similar between the 2 groups. At the genus level, the proportions of beneficial bacteria such as Faecalibacterium spp. (8.1% vs. 6.4%, P = 0.328) and Prevotella spp. (6.9% vs. 4.8%, P = 0.331) were higher, while that of Clostridium spp. was lower (0.5% vs. 1.2%, P = 0.121) in the immunonutrition group, but the difference was not significant. CONCLUSIONS: Immunonutrition showed no significant association with the composition of fecal microbiota. The relationship between immunonutrition and the fecal microbiota should be investigated further in large-scale studies.

Keywords

Acknowledgement

This study was supported by Chonnam National University Hwasun Hospital, Institute for Biomedical Science (grant numbers: HCRI19014 and HCRI20043).

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