Traditional Chinese and Western multidisciplinary team approach for gut microbiome recovery postintestinal stoma closure

Table 1 Baseline characteristics of patients in the control and multi-disciplinary team groups, n (%)

Baseline characteristics	Control group (n = 122)	MDT group (n = 129)	P value
Age (years), mean ± SD	55.2 ± 10.1	54.9 ± 9.8	0.723
Gender			0.845
Male	67 (55.0)	68 (52.7)
Female	55 (45.0)	61 (47.3)
BMI (kg/m²), mean ± SD	23.4 ± 3.1	23.6 ± 3.0	0.652
Duration of stoma (months), mean ± SD	8.5 ± 2.6	8.4 ± 2.5	0.876
Type of stoma			0.789
Ileostomy	72 (58.9)	75 (58.1)
Colostomy	50 (41.1)	54 (41.9)
Previous surgery count, mean ± SD	1.2 ± 0.4	1.3 ± 0.5	0.462
Chronic conditions			0.521
DM	17 (13.9)	16 (12.4)
HTN	15 (12.3)	15 (11.6)
Asthma	11 (9.0)	13 (10.1)
CKD	9 (7.4)	8 (6.2)
Heart disease	7 (5.7)	8 (6.2)	0.371
Preoperative Gut Symptom Score, mean ± SD	6.2 ± 1.5	6.3 ± 1.4	0.425
Psychological State Score, mean ± SD	3.1 ± 0.8	3.0 ± 0.7	0.538
Gut microbiome diversity, mean ± SD	3.5 ± 0.6	3.6 ± 0.5
Gut microbiome function, mean ± SD	2.8 ± 0.7	2.9 ± 0.6		0.614

BMI: Body mass index; DM: Diabetes mellitus; HTN: Hypertension; CKD: Chronic kidney disease; MDT: Multi-disciplinary team.

Table 2 Comparative analysis of gut microbiome operational taxonomic unit counts between groups

Gut microbiome characteristics	Control group (n = 122)	MDT group (n = 129)	P value
OTUs of Bacteroidetes	1.2 × 108 ± 5.0 × 107	1.4 × 108 ± 4.8 × 107	0.001
OTUs of Firmicutes	1.8 × 108 ± 6.3 × 107	1.7 × 108 ± 5.9 × 107	0.033
OTUs of Proteobacteria	6.1 × 107 ± 4.1 × 106	7.3 × 107 ± 3.7 × 106	< 0.001

OTUs: Operational taxonomic units; MDT: Multi-disciplinary team.

Table 3 Gastrointestinal symptoms and postoperative hospital stay in control and multi-disciplinary team groups, n (%)

Outcome measure	Control group (n = 122)	MDT group (n = 129)	P value
Number of patients reporting
Abdominal pain	38 (31.1)	20 (15.5)	0.003
Bloating	52 (42.6)	30 (23.3)	0.001
Diarrhea	29 (23.8)	12 (9.3)	0.014
Constipation	15 (12.3)	5 (3.9)	0.032
Postoperative hospital stay (days)
≤ 5 days	45 (36.9)	76 (58.9)	0.002
> 5 days	77 (63.1)	53 (41.1)	0.002

MDT: Multi-disciplinary team.

Table 4 Impact of the multi-disciplinary team approach on chronic condition management, n (%)

Chronic condition management	Control group (n = 122)	MDT group (n = 129)	P value
Medication reduction for DM	10 (8.2)	22 (17.1)	0.011
Medication reduction for HTN	12 (9.8)	25 (19.4)	0.019
Medication reduction for CKD	7 (5.7)	16 (12.4)	0.027

DM: Diabetes mellitus; HTN: Hypertension; CKD: Chronic kidney disease; MDT: Multi-disciplinary team.

Table 5 Nutritional status indicators between control and multi-disciplinary team groups

Nutritional status indicators	Control group (n = 122)	MDT group (n = 129)	P value
BMI change	-1.2 ± 0.4	-0.8 ± 0.3	0.009
Malnutrition prevalence	27 (22.1)	12 (9.3)	0.016
Serum sodium (mmol/L)	135 ± 3	137 ± 2	0.012
Serum potassium (mmol/L)	3.9 ± 0.4	4.1 ± 0.3	0.028
Serum calcium (mg/dL)	8.7 ± 0.6	9.0 ± 0.5	0.031
Vitamin B12 (pg/mL)	200 ± 40	220 ± 35	0.036
Vitamin D (ng/mL)	20 ± 5	25 ± 4	0.019
Daily caloric intake (kcal)	1800 ± 200	2000 ± 150	0.026
Protein intake (g/day)	60 ± 10	65 ± 8	0.017
Fiber intake (g/day)	20 ± 5	25 ± 4	0.024

BMI: Body mass index; MDT: Multi-disciplinary team.

Table 6 Intestinal permeability and quality of life in control and multi-disciplinary team groups, mean ± SD

Outcome measures	Control group (n = 122)	MDT group (n = 129)	P value
Intestinal permeability - lactulose/mannitol ratio	0.12 ± 0.03	0.09 ± 0.02	0.015
Quality of life - physical functioning (SF-36)	68.9 ± 8.4	77.5 ± 7.3	0.022
Quality of life - mental health (SF-36)	62.1 ± 9.2	70.4 ± 8.6	0.031
Quality of life - social functioning (SF-36)	73.2 ± 10.1	81.5 ± 9.4	0.029

SF-36: 36-Item Short Form Health Survey; MDT: Multi-disciplinary team.