PhD Scientific Days 2024

Budapest, 9-10 July 2024

Poster Session O - Surgical Medicine

Colon anastomosis healing could be effectively ameliorated by nutritional and physical prehabilitation


Klára Lévay1, Kovács Szabina1
1: Department of Surgery, Transplantation and Gastroenterology, Semmelweis University

Text of the abstract

Introduction:Colon anastomosis is one of the most common surgical procedures, however the occurrence of the anastomotic leakage is frequent. By bimodal prehabilitation (nutritional and physical treatments), the preoperative general condition of the patients and the gut microbiome could be expediently improved, which could maintain the prevalence of the anastomotic leakage.
Aims:Our aim was to study the effect of bimodal prehabilitation on colon anastomosis healing in a rat model.
Methods:108 male Wistar rats were divided into 6 groups: A: ad libitum fed; AE: ad libitum fed with exercise therapy; M: malnourished; ME: malnourished with exercise therapy; MN: malnourished with nutritional therapy; MNE: malnourished with nutritional and exercise therapy. During a 3 week-long period, A and M groups were created, then animals received a 4 week-long prehabilitation, thus AE, ME, MN, MNE groups were also formed. After the prehabilitation, the body composition was studied by magnetic resonance imaging and serum parameters (albumin, prealbumin, total protein) were measured. By 16S rRNA sequencing the composition of the gut microbiome was analyzed, and the gut circulation was measured as well. Preoperative testing was followed by colon resection and anastomosis, and anastomotic healing was investigated 0, 4, and 7 days after the surgery. Bursting pressure was determined and immunohistochemistry was performed to evaluate the levels of the tight junctions (occludin, claudin and zonula occludens-1).
Result:Preoperative body composition was adequate and significantly improved in the A, AE groups compared to the M group. In case of malnutrition, physical prehabilitation further worsened the status of the rats, while nutritional and bimodal prehabilitation were able to improve the preoperative status. Similar trend was found in each observed parameter, together with the laboratory testing, the microbiome composition, the gut circulation, the bursting pressure and the levels of tight junctions.
Conclusion:Colon anastomosis healing could be considerably ameliorated by bimodal prehabilitation, in case of malnutrition. Beneficial preoperative general condition and microbiome composition should be further investigated to increase the recovery rate after surgery in animal models as well as clinical practice.
Funding:Semmelweis University 250+ PhD Excellence Grant: 38898/DIDIT/2024