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In this study, we aimed to unravel longitudinal changes in microbial structure before, during, and after surgery and to determine if microbial alterations may be predictive for risk assessment between sufficient anastomotic healing (AS) and AL prior surgery. We analysed the microbiota of 134 colon mucosal biopsies with 16S rRNA V1-V2 gene sequencing. Samples were collected from three location sites before, during, and after surgery, and patients received antibiotics after the initial collection and during surgery. The microbial structure showed dynamic surgery-related changes at different time points. Overall bacterial diversity and the abundance of some genera such as\n                    <jats:italic>Faecalibacterium<\/jats:italic>\n                    or\n                    <jats:italic>Alistipes<\/jats:italic>\n                    decreased over time, while the genera\n                    <jats:italic>Enterococcus<\/jats:italic>\n                    and\n                    <jats:italic>Escherichia_Shigella<\/jats:italic>\n                    increased. The distribution of taxa between AS and AL revealed significant differences in the abundance of genera such as\n                    <jats:italic>Prevotella<\/jats:italic>\n                    ,\n                    <jats:italic>Faecalibacterium<\/jats:italic>\n                    and\n                    <jats:italic>Phocaeicola<\/jats:italic>\n                    . In addition to\n                    <jats:italic>Phocaeicola<\/jats:italic>\n                    ,\n                    <jats:italic>Ruminococcus2<\/jats:italic>\n                    and\n                    <jats:italic>Blautia<\/jats:italic>\n                    showed significant differences in abundance between preoperative sample types. ROC analysis of the predictive value of these genera for AL revealed an AUC of 0.802 (p\u2009=\u20090.0013). In summary, microbial composition was associated with postoperative outcomes, and the abundance of certain genera may be predictive of postoperative complications.\n                  <\/jats:p>","DOI":"10.1038\/s41598-024-65320-w","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T13:02:25Z","timestamp":1720011745000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prediction of anastomotic insufficiency based on the mucosal microbiome prior to colorectal surgery: a proof-of-principle study"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3213-8138","authenticated-orcid":false,"given":"Konrad","family":"Lehr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Undine Gabriele","family":"Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8888-1582","authenticated-orcid":false,"given":"Noam Mathias","family":"Hipler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6535-8212","authenticated-orcid":false,"given":"Ramiro","family":"Vilchez-Vargas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albrecht","family":"Hoffmeister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Feisthammel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorina","family":"Buchloh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2748-9929","authenticated-orcid":false,"given":"Denny","family":"Schanze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1618-9269","authenticated-orcid":false,"given":"Martin","family":"Zenker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7423-713X","authenticated-orcid":false,"given":"Ines","family":"Gockel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-4562","authenticated-orcid":false,"given":"Alexander","family":"Link","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3996-9391","authenticated-orcid":false,"given":"Boris","family":"Jansen-Winkeln","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,3]]},"reference":[{"key":"65320_CR1","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1136\/gutjnl-2015-310912","volume":"66","author":"M Arnold","year":"2017","unstructured":"Arnold, M. et al. 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