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Related Experiment Video

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Murine Ileocolic Bowel Resection with Primary Anastomosis
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A Pathologic Microbiome Impacts Post-Operative Anastomotic Healing.

Jeremy Chang1, Kristina Guyton1

  • 1Colon and Rectal Surgery, University of Iowa, Iowa City, Iowa, USA.

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|April 3, 2023
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Anastomotic leak after colorectal surgery is a serious complication. Modulating the gut microbiome to prevent pathogenic microbes may reduce leak rates and improve healing.

Keywords:
anastomosiscolorectal surgerydysbiosismicrobiomepathobiosis

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Area of Science:

  • Gastroenterology and Surgery
  • Microbiology
  • Wound Healing Research

Background:

  • Anastomotic leak following colorectal surgery is a severe complication with high mortality and morbidity.
  • Current strategies have not significantly reduced anastomotic leak rates over the past decade.
  • Adequate healing depends on collagen remodeling, which can be disrupted by microbial factors.

Approach:

  • Review of the gut microbiome's role in anastomotic healing and complications.
  • Exploration of specific microbes like Enterococcus faecalis and Pseudomonas aeruginosa in promoting leak.
  • Discussion of how stressors like antibiotics, diet, and infection induce a pathogenic microbiome (pathobiome).

Key Points:

  • Certain gut microbes can degrade collagen and activate enzymes that damage connective tissue.
  • These pathogenic microbes are found enriched in post-operative anastomotic tissues.
  • Dysbiosis, triggered by common stressors, can shift the microbiome towards a pathogenic state.

Conclusions:

  • Personalized microbiome modulation offers a potential strategy to improve anastomotic leak rates.
  • Emerging therapies like oral phosphate analogs and diet rehabilitation show promise.
  • Further human translational studies are needed to validate these microbiome-targeted interventions.