The aim of this pilot study was to evaluate the effects of a novel perioperative treatment for the implementation of the gut microbiota, to prevent anastomotic fistula and leakage (AL) in patients undergoing laparoscopic colorectal resections for cancer. A series of 60 patients who underwent elective colorectal surgery at S. Eugenio Hospital (Rome—Italy) between December 1, 2020 and November 30, 2021 and received a novel perioperative preparation following the MIRACLe (Micro- biota Implementation to Reduce Anastomotic Colorectal Leaks) protocol (oral antibiotics, mechanical bowel preparation and perioperative probiotics), was compared to a group of 500 patients (control group) operated on between March 2015 and November 30, 2020, who received a standard ERAS protocol. In the MIRACLe Group only 1 anastomotic leak was registered. In this group the incidence of AL was just 1.7% vs. 6.4% in the control group (p = 0.238) and the incidence of surgical site infections (1.7% vs. 3.6%; p = 0.686), reoperations (1.7% vs. 4.2%; p = 0.547) and postoperative mortality (0% vs. 2.2%; p = 0.504) were lower. The postoperative outcomes were also better: the times to first flatus, to first stool and to oral feeding were shorter (1 vs. 2, 2 vs. 3 and 2 vs. 3 days, respectively; p < 0.001). Additionally, the postoperative recovery was faster, with a shorter time to discharge (4 vs. 6 days; p < 0.001). In this pilot study, the MIRACLe protocol appeared to be safe and considerably reduced anastomotic leaks in elective laparoscopic colorectal surgery for cancer, even if not statisti- cally significant, due to the small number of cases.

Implementation of the gut microbiota prevents anastomotic leaks in laparoscopic colorectal surgery for cancer: the results of the MIRACLe study / Carlini, Massimo; Grieco, Michele; Spoletini, Domenico; Menditto, Rosa; Napoleone, Vincenzo; Brachini, Gioia; Mingoli, Andrea; Marcellinaro, Rosa. - In: UPDATES IN SURGERY. - ISSN 2038-3312. - 74:4(2022), pp. 1253-1262. [10.1007/s13304-022-01305-6]

Implementation of the gut microbiota prevents anastomotic leaks in laparoscopic colorectal surgery for cancer: the results of the MIRACLe study

Carlini, Massimo;Spoletini, Domenico;Menditto, Rosa;Napoleone, Vincenzo;Brachini, Gioia;Mingoli, Andrea;Marcellinaro, Rosa
2022

Abstract

The aim of this pilot study was to evaluate the effects of a novel perioperative treatment for the implementation of the gut microbiota, to prevent anastomotic fistula and leakage (AL) in patients undergoing laparoscopic colorectal resections for cancer. A series of 60 patients who underwent elective colorectal surgery at S. Eugenio Hospital (Rome—Italy) between December 1, 2020 and November 30, 2021 and received a novel perioperative preparation following the MIRACLe (Micro- biota Implementation to Reduce Anastomotic Colorectal Leaks) protocol (oral antibiotics, mechanical bowel preparation and perioperative probiotics), was compared to a group of 500 patients (control group) operated on between March 2015 and November 30, 2020, who received a standard ERAS protocol. In the MIRACLe Group only 1 anastomotic leak was registered. In this group the incidence of AL was just 1.7% vs. 6.4% in the control group (p = 0.238) and the incidence of surgical site infections (1.7% vs. 3.6%; p = 0.686), reoperations (1.7% vs. 4.2%; p = 0.547) and postoperative mortality (0% vs. 2.2%; p = 0.504) were lower. The postoperative outcomes were also better: the times to first flatus, to first stool and to oral feeding were shorter (1 vs. 2, 2 vs. 3 and 2 vs. 3 days, respectively; p < 0.001). Additionally, the postoperative recovery was faster, with a shorter time to discharge (4 vs. 6 days; p < 0.001). In this pilot study, the MIRACLe protocol appeared to be safe and considerably reduced anastomotic leaks in elective laparoscopic colorectal surgery for cancer, even if not statisti- cally significant, due to the small number of cases.
2022
microbiota; colorectal cancer; colorectal surgery; laparoscopy; anastomotic leak
01 Pubblicazione su rivista::01a Articolo in rivista
Implementation of the gut microbiota prevents anastomotic leaks in laparoscopic colorectal surgery for cancer: the results of the MIRACLe study / Carlini, Massimo; Grieco, Michele; Spoletini, Domenico; Menditto, Rosa; Napoleone, Vincenzo; Brachini, Gioia; Mingoli, Andrea; Marcellinaro, Rosa. - In: UPDATES IN SURGERY. - ISSN 2038-3312. - 74:4(2022), pp. 1253-1262. [10.1007/s13304-022-01305-6]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1649226
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