• S Gaines, C Shao, N Hyman, and J C Alverdy.
• Department of Surgery, Pritzker School of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 6090 Chicago, Illinois 60025, USA.
• Br J Surg. 2018 Jan 1; 105 (2): e131-e141.

BackgroundThe pathogenesis of colorectal cancer recurrence after a curative resection remains poorly understood. A yet-to-be accounted for variable is the composition and function of the microbiome adjacent to the tumour and its influence on the margins of resection following surgery.MethodsPubMed was searched for historical as well as current manuscripts dated between 1970 and 2017 using the following keywords: 'colorectal cancer recurrence', 'microbiome', 'anastomotic leak', 'anastomotic failure' and 'mechanical bowel preparation'.ResultsThere is a substantial and growing body of literature to demonstrate the various mechanisms by which environmental factors act on the microbiome to alter its composition and function with the net result of adversely affecting oncological outcomes following surgery. Some of these environmental factors include diet, antibiotic use, the methods used to prepare the colon for surgery and the physiological stress of the operation itself.ConclusionInterrogating the intestinal microbiome using next-generation sequencing technology has the potential to influence cancer outcomes following colonic resection.© 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

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