The role of dietary prehabilitation on anastomotic healing

As the microbiome takes center stage in biomedical research and emerging medical treatments, here we review the scientific basis and role of dietary modulation to prevent anastomotic leakage.

It is becoming increasingly clear that dietary habits have a profound influence on an individual's microbiome and that the microbiome plays a key and causative role in anastomotic leak etiology and pathogenesis. A review of recent studies indicates that the gut microbiome can become significantly shifted in composition, community structure and function within an extremely short time period of 2 or 3 days simply by changing one's diet.

From a practical standpoint to improve outcome from surgery, these observations, when paired with next generation technology, suggest that it is now possible to manipulate the microbiome of surgical patients to their advantage prior to surgery. This approach will allow surgeons to modulate the gut microbiome with the endpoint of improving the outcome from surgery. Thus a new emerging field termed 'dietary prehabilitation' is now gaining popularity and similar to smoking cessation, weight loss and exercise, may be a practical method to prevent postoperative complications including anastomotic leak.