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Updated: Mar 8, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
The gut microbiome and the mechanism of surgical infection
J C Alverdy1, S K Hyoju1, M Weigerinck2
1Department of Surgery and Laboratory of Surgical Infection Research and Therapeutics, University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA.
Background:
Since the very early days of surgical practice, surgeons have recognized the importance of considering that intestinal microbes might have a profound influence on recovery from surgical diseases such as appendicitis and peritonitis. Although the pathogenesis of surgical diseases such as cholelithiasis, diverticulosis, peptic ulcer disease and cancer have been viewed as disorders of host biology, they are emerging as diseases highly influenced by their surrounding microbiota.
Methods:
This is a review of evolving concepts in microbiome sciences across a variety of surgical diseases and disorders, with a focus on disease aetiology and treatment options.
Results:
The discovery that peptic ulcer disease and, in some instances, gastric cancer can now be considered as infectious diseases means that to advance surgical practice humans need to be viewed as superorganisms, consisting of both host and microbial genes. Applying this line of reasoning to the ever-ageing population of patients demands a more complete understanding of the effects of modern-day stressors on both the host metabolome and microbiome.
Conclusion:
Despite major advances in perioperative care, surgeons today are witnessing rising infection-related complications following elective surgery. Many of these infections are caused by resistant and virulent micro-organisms that have emerged as a result of human progress, including global travel, antibiotic exposure, crowded urban conditions, and the application of invasive and prolonged medical and surgical treatment. A more complete understanding of the role of the microbiome in surgical disease is warranted to inform the path forward for prevention.
Insights
Surgical outcomes are increasingly linked to the gut microbiome. Understanding the complex interplay between host and microbial genes is crucial for advancing surgical practice and preventing rising infection-related complications.
Area of Science:
- Surgical Science
- Microbiome Research
- Infectious Disease
Background:
- Surgeons have long suspected the influence of intestinal microbes on surgical disease recovery.
- Diseases like appendicitis, peritonitis, cholelithiasis, diverticulosis, peptic ulcer disease, and cancer are now understood to be significantly impacted by the microbiota.
Purpose of the Study:
- To review evolving concepts in microbiome sciences relevant to surgical diseases.
- To focus on disease etiology and treatment strategies influenced by the microbiome.
Main Methods:
- This study is a comprehensive review of current literature on the microbiome in surgical contexts.
- It examines the impact of microbial factors on the pathogenesis and management of various surgical conditions.
Main Results:
- Peptic ulcer disease and some gastric cancers are now recognized as infectious diseases.
- Viewing humans as superorganisms (host + microbial genes) is essential for advancing surgical practice.
- Understanding the microbiome's role is vital for an aging population facing modern stressors.
Conclusions:
- Rising infection-related complications post-elective surgery are a growing concern.
- Resistant microbes, fueled by global travel and antibiotic use, contribute to these complications.
- Further research into the microbiome's role in surgical disease is necessary for effective prevention strategies.
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