INULIN AND GALACTO-OLIGOSACCHARIDES IMPROVE COLONIC ANASTOMOTIC HEALING IN MICE UNDERGOING COLORECTAL SURGERY
Roy Hajjar*1,2,4, Manon Oliero1,4, Thibault Cuisiniere1,4, Gabriela Fragoso1, Annie Calvé1, Souad Djediai3, Borhane Annabi3, Carole Richard2,4, Manuela M. Santos1,4
1Centre Hospitalier de l'Universite de Montreal Centre de Recherche, Montreal, QC, Canada; 2Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada; 3Universite du Quebec a Montreal, Montreal, QC, Canada; 4Universite de Montreal, Montreal, QC, Canada
Anastomotic leak (AL) is a major complication in colorectal surgery. Recent evidence suggests that the gut microbiota may affect healing and may cause or prevent AL. Butyrate is a beneficial short-chain fatty acid that is produced as a result of bacterial fermentation of dietary oligosaccharides and is beneficial in the maintenance of colonic health. As such, butyrate may enhance anastomotic healing.
We aimed to prevent AL by increasing the bacterial production of butyrate in the colon via dietary supplementation of oligosaccharides, namely inulin and galacto-oligosaccharides (GOS).
Diets supplemented with inulin or GOS, or with cellulose as a control, were administered ad libitum to mice for two weeks. Mice were then subjected to a proximal colonic anastomosis under general anesthesia. They were followed postoperatively and sacrificed six days after surgery. Anastomotic healing was assessed macroscopically and microscopically. The preservation of the extracellular matrix at the wound site and barrier integrity were also evaluated.
Inulin and GOS-supplemented diets were associated with an increase of butyrate levels in the colon. When compared to cellulose, diets supplemented with oligosaccharides improved macroscopic and microscopic anastomotic healing. They were also associated with higher collagen concentration at the wound site and lower bacterial translocation.
Oligosaccharides, including inulin and GOS, seem to promote anastomotic healing and prevent AL after colorectal surgery in mice. This effect may be associated with enhanced collagenization of the wound resulting in an improved barrier.
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