INtestinal Dysbiosis and TRanslocation of Bacteria in Patients Undergoing Surgery

N/AActive Not RecruitingNCT05775341

Insel Gruppe AG, University Hospital Bern120 enrolled

Overview

The goal of this observational study is to contribute to a better understanding of the perioperative kinetics of intestinal microbial composition and association with surgical site infections. The main question this study aims to determine if: * Patients undergoing surgery develop transient intestinal dysbiosis * Such transient dysbiosis is associated with translocation to the systemic circulation and surgical site infection Patients undergoing elective abdominal surgery will be included prospectively. Informed consent will be obtained. From patients the following information and samples will be collected: * Perioperative: Baseline health data, nutrition data, measurement body composition, glucose monitoring * Intraoperatively: * Mucosal swabs * Blood from central venous catheter and portal vein * Mesenteric lymph node * Intestinal specimen * Bile * Subcutaneous biopsy * Postoperatively: * If a surgical site infection occurs samples from infected site

Study Type

OBSERVATIONAL

Enrollment

120

Conditions

Surgical Site Infection

Interventions

No InterventionOTHER

This is purely an observational study.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion criteria: * Patients undergoing laparoscopic colorectal resection with anastomosis or patients undergoing duodeno-pancreatectomy. * Elective surgery * Informed consent * Age \> 18 years Exclusion criteria: * Emergency surgery * Other surgery 30 days prior to surgery * BMI \<18 or \>50kg/m2 * Planed simultaneous second procedure with involvement of the intestinal tract * Cholestasis with cholangitis, hepatic disease (defined as cirrhosis Child B or C) or renal disease (acute or chronic renal failure defined as eGFR≤ 30ml/min) * Severe active enteritis or colitis, malabsorption, enteric infections * Pancreatitis

Outcomes

Primary Outcomes

Changes of the intestinal microbiome between start and end of surgery

Score between PCA (principal components analysis) in the intestine between start (T1) and end (T2) of surgery. * Sampling: An intestinal specimen is dissected at start and end of elective pancreatic resections. * Processing: Samples are immediately processed for storage at -80° in glycerol. * Analysis: Quantification of total Biomass, DNA extraction, preparation of Bacterial DNA libraries, sequencing with Illumina system, downstream analysis, statistical analysis, principal components analysis (PCA) with all the samples is performed and the score is defined based on the distance between the two centers in PC1 and PC2 of T1 versus T2.