Changes in gut microbial flora after Roux-en-Y gastric bypass and sleeve gastrectomy and their effects on post-operative
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ORIGINAL ARTICLE
Changes in gut microbial flora after Roux‑en‑Y gastric bypass and sleeve gastrectomy and their effects on post‑operative weight loss Reza Karami1 · Mohammad Kermansaravi1,2 · Mohaddese Pishgahroudsari3 · Malihe Talebi4 · Nima Mohammadzadeh4 · Abdolreza Pazouki1,2 Received: 24 August 2020 / Accepted: 8 October 2020 © Italian Society of Surgery (SIC) 2020
Abstract Bariatric surgery affects gut microbial flora due to the anatomical and physiological changes it causes in the gastrointestinal tract. Understanding the interaction between the gut flora, the type of bariatric surgery and weight loss may help improve bariatric surgery outcomes. This study was designed to compare the effects of Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) on two main phyla of the gut microbiota in humans and evaluate their potential effect on weight changes. Thirty morbidly obese patients were divided into two groups and underwent laparoscopic SG or laparoscopic RYGB. The patients’ weight changes and fecal samples were evaluated at baseline and 6 months after the surgery. A microbial flora count was carried out of the phyla Bacteroidetes and Firmicutes and Bacteroides Fragilis. Changes in the abundance of the flora and their correlation with weight loss were analyzed. After 6 months, the patients with a history of RYGB showed a significant decrease in stool Bacteroidetes while the reduction in the SG group was insignificant. Firmicutes abundance was almost unchanged following SG and RYGB. There was no significant change in Bacteroides Fragilis abundance in either of the two groups, but a positive correlation was observed between Bacteroides Fragilis and weight loss after SG and RYGB. Bariatric surgery can affect gut microbiota. It can be concluded that these changes are dependent on many factors and may play a role in weight loss. Keywords Sleeve gastrectomy · Roux en Y gastric bypass · Microbial flora · Weight
Introduction The number of obese and overweight people has doubled across the world since 1980. As of 2014, 52% of adults were overweight or obese, and morbid obesity is currently a public health problem [1]. Obesity increases the risk of * Mohammad Kermansaravi [email protected]; [email protected] 1
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Rasool-E-Akram Hospital, Tehran, Iran
2
Center of Excellence of of European Branch of International Federation for Surgery of Obesity, Hazrat-E-Rasool Hospital, Tehran, Iran
3
BS, Statistics Analyzer, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
4
Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
life-threatening diseases, including type-2 diabetes, arterial hypertension, coronary heart disease, and cancer [2]. Although physical inactivity and inappropriate eating habits play a role in weight gain, studies suggest that genes are also responsible for obesity [3]. Obesity affects the intestinal
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