Microbiome Influence on Colorectal Surgical Outcomes

The gut microbiome plays a pivotal role in governing postoperative recovery and complication rates following colorectal surgery. Microbial communities at and around the surgical site interact with host tissues to influence inflammation, wound healing and barrier integrity. Dysbiosis—defined as an imbalance in microbial composition—can predispose to anastomotic leakage, surgical-site infection and delayed mucosal regeneration. Conversely, a resilient microbiota, rich in commensal anaerobes and short-chain fatty acid producers, supports extracellular matrix remodelling and immunomodulation, thereby enhancing anastomotic strength. Perioperative factors such as mechanical bowel preparation, prophylactic antibiotics and dietary interventions can perturb microbial ecology, sometimes with unintended adverse effects. Emerging evidence points to the potential of microbiota-targeted strategies—ranging from preoperative dietary modulation and probiotic or synbiotic administration to precision faecal microbial transplantation—to reduce complication rates and improve long-term oncological outcomes. Together, these insights underscore the microbiome as both a biomarker and a therapeutic target in the optimisation of colorectal surgical care.

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Microbiome Influence on Colorectal Surgical Outcomes publication trend

The graph below shows the total number of articles in microbiome influence on colorectal surgical outcomes across all publications each year (not limited to Nature Index journals).

Technical terms

Anastomotic leakage: Failure of a surgically created connection between two sections of intestine, leading to leakage of luminal contents.

Dysbiosis: Disruption of the normal balance of microbial communities, often characterised by reduced diversity and overrepresentation of pathogenic taxa.

Short-chain fatty acids: Microbial fermentation products (e.g., butyrate) that support mucosal integrity, modulate inflammation and promote wound healing.

Faecal microbial transplantation (FMT): Transfer of processed stool from a healthy donor to a recipient to restore microbial diversity and function.

Perioperative modulation: Interventions applied before, during or after surgery aimed at optimising the microbial environment to improve clinical outcomes.

References

1. Diet-induced shifts in the gut microbiota influence anastomotic healing in a murine model of colonic surgery. Gut Microbes (2023).
2. The implication of gut microbiota in recovery from gastrointestinal surgery. Frontiers in Cellular and Infection Microbiology (2023).
3. Gut Microbiota—Adversary or Ally? Its Role and Significance in Colorectal Cancer Pathogenesis, Progression, and Treatment. Cancers (2024).