Influence of different regimens of volumetric therapy on perioperative intestinal flora in the surgical patients with pancreas tumor, a randomized controlled trial study

BACKGROUND: It is not clear whether the perioperative intestinal microenvironment of patients undergoing pancreatic tumor surgery is affected by intraoperative fluid therapy. METHOD: Fifty-eight patients who underwent a confined excision of pancreas mass at this center were enrolled. The patients were grouped according to the random number table in these two groups: the liberal fluid infusion (LFI) group and the goal-directed fluid therapy (GDFT) group. Perioperative anesthesia management was carried out by the same team of anesthesiologists according to a preset anesthetic protocol. Fecal samples were collected twice: within 2 days before the surgery and at 6 to 8 days postoperatively. The collected fecal samples were sequenced through microbial diversity high-throughput 16 s-rDNA; and the differential changes of intestinal flora were analyzed. RESULTS: Main components of flora in the sample were significantly different between LFI and GDFT groups. As shown by the difference in species, in GDFT group, more constituent bacteria participated in the metabolism inside human body and the restoration of coagulation function, including: prevotella, roseburia, lachnospiracea, dialister and clostridium (P < 0.05); in LFI group, more constituent bacteria were opportunistic pathogenic bacteria, including: enterococcus, pseudomonas aeruginosa, and acinetobacter baumannii (P < 0.05). CONCLUSION: For surgical patients with pancreas tumor, there are significant differences of intestinal flora in diversity between GDFT and LFI. GDFT seems to play a more important role in protection and restoration of intestinal flora. CLINICAL TRIAL REGISTRATION: ChiCTR2000035187.