• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • SAGES 2021 Annual Meeting
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2021
      • SAGES 2020
      • SAGES 2019
      • SAGES 2018
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • SAGES Logo Products
    • “Unofficial” Logo Products
  • Log In

Metabolic Profiling of Urine Reveals Distinct Phenotypic Changes in Patients Undergoing Colorectal Excision

Sunreet Randhawa, Reza Mirnezami, Beatriz Jimenez, James Kinross, Olaf Beckonert, Claire Merrifield, Elaine Holmes, Jeremy Nicholson, Ara Darzi. Section of Biomolecular Medicine and Section of Biosurgery and Surgical Technology, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK.

 

INTRODUCTION

Systems biology has yet to be widely adopted for surgical use however this technology is highly applicable for the development of individualised surgical therapeutics. Colorectal surgery disrupts the gut microbiota and important symbiotic co-metabolic pathways which may be indirectly measured in urine via this approach. This study aimed to determine if a metabolic phenotype exists for the anatomical resection or the invasiveness of surgical approach which accounts for the role of the gut microbiota in mammalian metabolism.

 

METHODS AND PROCEDURES

27 colorectal cancer (CRC) patients undergoing open or laparoscopic elective surgery for colorectal cancer (CRC) were recruited prospectively at St Mary’s Hospital, London, UK. Urine sampling was performed preoperatively on the morning of surgery and on the 3rd postoperative day. Samples were frozen at -800C. A metabolic, pharmacological and clinical history was taken and oncological staging and grading data were recorded. Urine samples were analysed by high resolution 1H NMR spectroscopy using a Bruker 600 MHz Spectrometer. Spectra consisting of 32,000 data points were phase and base line corrected using TopSpin (Bruker BioSpin, Germany). Raw data were exported into SIMCA 12 and Matlab for multivariate analysis by principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) models. Water and urea were excluded from the spectra.

 

RESULTS

The median age was 68 (range 47-84) and the male:female ratio was 16:11.There were 11 laparoscopic and 16 open procedures (3 laparoscopic cases were converted to open). Cases comprised: left hemicolectomy (n=8), right hemicolectomy (n=8), anterior resection (n=10) and abdomino-perineal resection (n=1). Cancers were staged according to UICC criteria as stage 1 (n=6), stage 2 (n=8), stage 3 (n=9) and stage 4 (n=4). Unsupervised multivariate analysis of pre-operative urine samples revealed significant metabolic variability according to the anatomical site of the tumour (R2 = 0.46). Creatinine statistically correlated with rectal cancer while colonic cancers demonstrated higher levels of hippurate and aromatic compounds strongly identified as gut microbial co-metabolites. OPLS-DA was able to strongly predict the pre- and postoperative states (R2y (cum)= 0.65; Q2 (cum)= 0.63). In addition, postoperative analysis identified markedly differing urinary metabolic profiles between patients undergoing right versus left hemicolectomy (R2y (cum)= 0.65; Q2 (cum)= 0.63, see figure) and rectal versus colonic surgery (R2y (cum)= 0.65; Q2 (cum)= 0.63). Furthermore, we identified statistical variability between laparoscopic and open cases (R2y (cum)= 0.717; Q2 (cum)= 0.22).

 

CONCLUSION

Urinary metabolic profiling provides a systems overview of the complex response to colorectal surgery and serves as an important scientific platform for the development of personalised surgical therapies. It is able to achieve this in part by non-invasively measuring gut microbial co-metabolic pathways and systems biology is of benefit in determining the beneficial metabolic affects of minimally invasive surgery.


Session Number: Poster – Poster Presentations
Program Number: P020
View Poster

131

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Surgery is Safer with Vaccination 1

Addressing Religious Concerns About COVID-19 Vaccine

This may be a difficult subject matter for you and your patient to talk about.  Be assured, all major organized religious groups encourage and recommend the COVID-19 vaccine. Listed below are references and websites you can direct your patient towards to help them make an informed decision with regards to their religious concerns against the […]

SAGES Statement on AAPI Violence

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) stands in solidarity with the Asian American and Pacific Islander (AAPI) community. In the summer of 2020, SAGES released a statement condemning the violence, racism, and hatred toward the Black community in the wake of George Floyd and Breonna Taylor’s murders. It is with great sorrow […]

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
[email protected]
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2022 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2022 Society of American Gastrointestinal and Endoscopic Surgeons