PhD Scientific Days 2026

Poster Session 2.T - Surgical Medicine

Prehabilitation with prebiotic supplements prevents intestinal inflammation and anastomotic leak through the gut microbiota

Name of the presenter

Kovács, Szabina

Institute/workplace of the presenter

Department of Surgery, Transplantation and Gastroenterology

Authors

Szabina Kovacs¹, Krisztian Szigeti², Krisztian Laczi³, Balint Hofmeister⁴, Nora Makra⁴, Zsuzsanna Dunai⁴, Eszter Ostorhazi⁴, Andras Budai⁵, Balazs Banky¹, Attila Szijarto¹, Andras Fulop¹
1: Semmelweis University; Department of Surgery, Transplantation and Gastroenterology
2: Semmelweis University; Department of Biophysics and Radiation Biology
3: University of Szeged; Institute of Biology; Faculty of Science and Informatics; Department of Biotechnology and Microbiology
4: Semmelweis University; Institute of Medical Microbiology
5: Semmelweis University; Department of Pathology, Forensic and Insurance Medicine

Text of the abstract

Anastomotic leakage represents one of the most severe complications in colorectal surgery. Emerging evidence suggests that the gut microbiome is implicated in the development of anastomotic complications. Restoring microbial balance by augmenting beneficial and decreasing pathogenic bacteria could potentially serve as a strategy to prevent anastomotic leak. Prebiotics are plant-derived fibers that promote the growth of beneficial microbes and may therefore enhance surgical outcomes. However, evidence for their effectiveness is limited.
We aimed to investigate the effect of preoperative prebiotic supplementation on colonic inflammation and anastomotic healing.
76 male Wistar rats were allocated into standard (S), prebiotic-treated (P) and corresponding colitis groups (SC, PC). After 4 weeks of pretreatments, chemically induced colitis was initiated until surgery, where colon resection was performed with primary anastomosis. Preoperative microbial composition was evaluated through 16S rRNA gene sequencing. Changes in Disease Activity Index (DAI), colon weight/length ratio, histopathological inflammatory reaction, mucosal fold length and crypt depth were measured to determine colitis severity. Postoperative outcomes and anastomotic healing were evaluated through survival, macroscopic assessment of adhesions, anastomotic bursting pressure, hydroxiproline and matrix metalloproteinase (MMP) levels.
Prehabilitation with prebiotics improved microbial composition. The reduced alpha diversity and unfavorable compositional shift observed in SC compared to S diminished in the PC group. Prebiotic pretreatment reduced the extent of intestinal damage, which was evidenced by the improvement of the DAI, colon weight-to-length ratio, length of mucosal folds and crypts in the PC group compared to the SC. Preoperative prebiotic supplementation improved postoperative outcomes, supported by enhanced survival, fewer adhesions, higher anastomotic bursting pressure, increased hydroxyproline and reduced MMP levels in the PC group compared to the SC.
Our results suggest that preoperative prebiotic supplementation prevents inflammatory flare-ups and improves intestinal anastomotic healing. Therefore, it is important to consider incorporating prebiotics into prehabilitation protocols for appropriate patient groups.
Semmelweis University 250+ PhD Excellence Grant (134534/DIDIT/2025)