A229 PROMOTION OF COLONIC ANASTOMOTIC HEALING WITH PERIOPERATIVE SUPPLEMENTATION WITH OLIGOSACCHARIDES

Abstract

\n \n \n Colorectal resection is a standard procedure in the management of colorectal cancer (CRC) and inflammatory bowel disease. Anastomotic leak (AL) is a major complication in colorectal resections, and the gut microbiota may play a role in the healing and development of AL. Short-chain fatty acids (SCFAs), namely butyrate, have been involved in anastomotic healing when administered into the bowel via enema. Due to the mechanical stress associated with enemas after the confection of a fresh and fragile anastomosis, other butyrate-increasing strategies are required.\n \n \n \n To promote anastomotic healing and prevent AL by using inulin and galacto-oligosaccharides (GOS) supplementation to modulate the microbiota toward a butyrate-producing profile.\n \n \n \n Mice were fed diets supplemented with inulin, GOS or cellulose, as a non-fermentable control, for two weeks and underwent a proximal colonic anastomosis under general anesthesia. Healing of the anastomosis, both macroscopically and microscopically, was assessed six days after surgery. Epithelial proliferation, mucus production and integrity of the gut barrier were assessed.\n \n \n \n Inulin and GOS supplementation increased SCFAs in the colon and were associated with better postoperative weight recovery and macroscopic anastomotic healing. Microscopically, mucosal continuity was promoted by inulin and GOS. Mucus production was found to be similar in all groups. The gut barrier was found to be improved with inulin and GOS as shown by less bacterial translocation.\n \n \n \n Inulin and GOS may prevent AL and promote anastomotic healing. This effect appears to be mediated by improved mucosal proliferation.\n \n \n \n CIHRNatural Sciences and Engineering Research Council of Canada; Institut du cancer de Montréal; Fonds de recherche du Québec en santé\n