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: 
0 
Date: 
22 May 2021
Reviewer's report:
This is 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. In my opinion, to be considered for publication, the authors
need to address the following comments:
Major revisions
1. A previously reported classification of intestinal dysbacteriosis was used in
the study. Please include representative Gram stain images of the stool samples
for each dysbacteriosis grade. 
2. There are papers in the literature that have investigated preoperative intestinal
dysbiosis in colorectal cancer utilizing sequencing technology (e.g., 16S rRNA
gene targeted sequencing). The authors suggested the use of Gram staining as an
economical method to predict postoperative infectious outcomes. Please include
a discussion on comparing the results and effectiveness of the methods. 
3. Please include the antibiotic drugs and regimen used in the surgeries in Table
5. 
4. Please include the discussion of possible mechanisms of preoperative
dysbacteriosis on causing surgical site infections. 
Minor revisions
1. In the abstract, please place the abbreviation, SSI, after the first mention of
surgical site infection. 
2. In the abstract methods "A consecutive of 353….", please revise into "A
consecutive of 353 patients who underwent colorectal cancer surgery were
enrolled."
3. References 1 and 2 are inappropriate citations. Please cite the original research
articles. 
4. Blood glucose greater than 150 mg/dL is known as a risk factor for surgical
site infections. Please consider including blood glucose data in the analysis if
available. 
5. Reference formats are inconsistent. Please use the same format for all the
references. 
6. Overall, the writing style is wordy with many long sentences, grammatical
errors, and inconsistent formats (e.g., double spaces in Line 12). Please seek
professional English editing and polish the manuscript to further improve clarity.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
No
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests.
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
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
Is the use of statistics and treatment of uncertainties appropriate?
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