Bariatric surgery is the most effective treatment for weight loss. Vertical sleeve gastrectomy (VSG) involves the resection of ~ 80% of the stomach and was conceived to purely restrict oral intake. However, evidence suggests more complex mechanisms, particularly postoperative changes in gut microbiota, in facilitating weight loss and resolving associated comorbidities. VSG in humans is a complex procedure and includes peri-operative antibiotics and caloric restriction in addition to the altered anatomy. The impact of each of these factors on the intestinal microbiota have not been evaluated. The aim of this study was to determine the relative contributions of each of these factors on intestinal microbiota composition following VSG prior to substantial weight loss. Thirty-two obese patients underwent one of three treatments: (1) VSG plus routine intravenous peri-operative antibiotics (n = 12), (2) VSG with intravenous vancomycin chosen for its low intestinal penetrance (n = 12), and (3) caloric restriction (n = 8). Fecal samples were evaluated for bacterial composition prior to and 7 days following each intervention. Only patients undergoing VSG with routine peri-operative antibiotics showed a significant shift in community composition. Our data support the single dose of routine peri-operative antibiotics as the most influential factor of intestinal microbial composition acutely following VSG.

减肥手术是最有效的减肥方法。垂直袖胃切除术（VSG）涉及切除约80％的胃，被认为纯粹是限制了口腔的摄入。但是，有证据表明，在减轻体重和解决相关合并症方面，机制更为复杂，尤其是肠道菌群的术后改变。VSG在人体中是一个复杂的过程，除了解剖结构改变外，还包括围手术期使用的抗生素和热量限制。这些因素中的每一个对肠道菌群的影响尚未评估。这项研究的目的是确定在体重明显减轻之前，VSG后这些因素对肠道菌群组成的相对影响。32名肥胖患者接受了以下三种治疗方法之一：（1）VSG加常规围手术期静脉使用抗生素（n = 12），（2）选择VSG并采用静脉万古霉素治疗，因为其肠道渗透率低（n = 12），以及（3）热量限制（n = 8）。在每次干预之前和之后7天评估粪便样品的细菌组成。只有接受常规围手术期抗生素治疗的VSG患者的社区组成发生了重大变化。我们的数据支持单一剂量的常规围手术期抗生素是VSG急性后肠道微生物组成的最重要影响因素。仅接受常规围手术期抗生素治疗的VSG患者的社区组成发生了重大变化。我们的数据支持单一剂量的常规围手术期抗生素是VSG急性后肠道微生物组成的最重要影响因素。只有接受常规围手术期抗生素治疗的VSG患者的社区组成发生了重大变化。我们的数据支持单一剂量的常规围手术期抗生素是VSG后急性影响肠道微生物组成的最重要因素。