Review for 10.1186/s12876-021-02035-6 (2021)

Reviewer’s report
Title: 
The effects of preoperative intestinal dysbacteriosis on postoperative
recovery in colorectal cancer surgery: a prospective cohort study
Version: 
1 
Date: 
30 Aug 2021
Reviewer's report:
The authors describe a prospective cohort study on effects of preoperative
intestinal dysbacteriosis on postoperative recovery in patients who underwent
colorectal cancer surgery. The authors claimed that this is the first study to
highlight the association between preoperative stool dysbacteriosis and
postoperative infectious outcomes. 
Thank you for the revisions and splitting the analyses between colon and rectal
cancer. In my opinion, to be considered for publication, the authors need to
address the following comments:
1. The authors have attached gram stain images to the manuscript. Please edit
and adjust the images to leave out the black background and provide the
magnifications. Shimizu et al. Dig Dis Sci 2011 can be used as a reference. 
2. Please consider moving Figure 4 Flow Diagram of Patient Recruitment before
the gram stain images. The study design and patient recruitment are mentioned
before the fecal assays in the methods section. 
3. A study recently published in JAMA suggests higher preoperative dietary
fiber intake is associated with a lower risk of postoperative complications among
patients with colorectal cancer. Please include the role of habitual dietary fiber
intake in your discussion. 
4. The sentence in the conclusion of the abstract "However, the contribution of
preoperative dysbacteriosis..." is missing in the conclusion of the manuscript.
Please include this in the conclusion on page 19. 
5. Studies have shown Fusobacterium nucleatum to be pro-tumorigenic, please
include it in your discussion about dysbiosis and oncogenesis of colorectal
cancer on page 15.
6. Please add the word "Dysbacteriosis" above "Grade 1" in Table 1 for
consistency. 
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
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Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes