Synergistic Strategies for Gastrointestinal Cancer Care: Unveiling the Benefits of Immunonutrition and Microbiota Modulation

Unravelling the role of intratumoral bacteria in digestive system cancers: current insights and future perspectives

Recently, research on the human microbiome, especially concerning the bacteria within the digestive system, has substantially advanced. This exploration has unveiled a complex interplay between microbiota and health, particularly in the context of disease. Evidence suggests that the gut microbiome plays vital roles in digestion, immunity and the synthesis of vitamins and neurotransmitters, highlighting its significance in maintaining overall health. Conversely, disruptions in these microbial communities, termed dysbiosis, have been linked to the pathogenesis of various diseases, including digestive system cancers. These bacteria can influence cancer progression through mechanisms such as DNA damage, modulation of the tumour microenvironment, and effects on the host's immune response. Changes in the composition and function within the tumours can also impact inflammation, immune response and cancer therapy effectiveness. These findings offer promising avenues for the clinical application of intratumoral bacteria for digestive system cancer treatment, including the potential use of microbial markers for early cancer detection, prognostication and the development of microbiome-targeted therapies to enhance treatment outcomes. This review aims to provide a comprehensive overview of the pivotal roles played by gut microbiome bacteria in the development of digestive system cancers. Additionally, we delve into the specific contributions of intratumoral bacteria to digestive system cancer development, elucidating potential mechanisms and clinical implications. Ultimately, this review underscores the intricate interplay between intratumoral bacteria and digestive system cancers, underscoring the pivotal role of microbiome research in transforming diagnostic, prognostic and therapeutic paradigms for digestive system cancers.

A Comparative Study Between the Early and Late Enteral Nutrition After Gastrointestinal Anastomosis Operations

INTRODUCTION

Intestinal anastomosis is a surgical procedure crucial for restoring the integrity of the digestive system and finds widespread application in addressing diverse gastrointestinal disorders such as tumors, inflammatory conditions, and traumatic injuries. The timing of restarting feeding after the surgery is a debated topic due to its potential impact on patient recovery. Early enteral feeding, administered soon after surgery, aims to counteract the negative effects of prolonged fasting and improve outcomes.

OBJECTIVE

This study analyzed the early and late enteral feeding following gastrointestinal anastomosis surgery.

METHODS

Forty patients undergoing abdominal surgery were prospectively randomized into early or late feeding groups. Demographics, laboratory values, operative time, blood loss, transfusion rates, nasogastric tube (NGT) removal, hospital stay, gastrointestinal recovery, postoperative body mass index (BMI), and complications were compared. Data was organized in Excel and analyzed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 27.0, Armonk, NY). Qualitative data were presented with numbers and percentages, while parametric quantitative data used means, standard deviations, and ranges. Non-parametric quantitative data were represented with medians and interquartile ranges. Chi-square tests were used for comparing two qualitative groups with predicted counts less than 5, while independent t-tests and Mann-Whitney tests were employed for comparing two quantitative groups with parametric and non-parametric distributions, respectively. The analysis used a 95% confidence interval, a 5% margin of error, and considered P values less than 0.05 as significant.

RESULTS

Early feeding was associated with significantly shorter NGT removal times (p=0.005) and hospital stays (p=0.001) than late feeding. Postprandial potassium levels were higher in the early group (p=0.007), while CRP levels were significantly lower (p=0.004). No significant differences were found in operative time, blood loss, transfusion rates, gastrointestinal recovery, postoperative BMI, or complication rates between groups.

CONCLUSIONS

Early enteral feeding appears safe and effective after gastrointestinal anastomosis surgery, potentially reducing hospital stay and improving inflammatory markers without increasing adverse events.