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Clin Colon Rectal Surg 2021; 34(06): 439-446
DOI: 10.1055/s-0041-1735276
Review Article

Influence of the Microbiome on Anastomotic Leak

Ashley J. Williamson
1   Department of Surgery, University of Chicago, Chicago, Illinois
,
John C. Alverdy
1   Department of Surgery, University of Chicago, Chicago, Illinois
› Author Affiliations Funding The authors have no financial disclosures significant to the work presented.
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Abstract

Despite advances in surgical technique and the expanded use of antibiotics, anastomotic leak remains a dreaded complication leading to increased hospital length of stay, morbidity, mortality, and cost. Data continues to grow addressing the importance of a functional and diverse colonic microbiome to ensure adequate healing. Individual pathogens, such as Enterococcus faecalis and Pseudomonas aeruginosa, have been implicated in the pathogenesis of anastomotic leak. Yet how these pathogens proliferate remains unclear. It is possible that decreased microbial diversity promotes a shift to a pathologic phenotype among the remaining microbiota which may lead to anastomotic breakdown. As the microbiome is highly influenced by diet, antibiotic use, the stress of surgery, and opioid use, these factors may be modifiable at various phases of the surgical process. A large amount of data remains unknown about the composition and behavior of the “normal” gut microbiome as compared with an altered community. Therefore, targeting the gut microbiome as a modifiable factor in anastomotic healing may represent a novel strategy for the prevention of anastomotic leak.

Keywords

microbiome - anastomotic leak - healing


Publication History

Article published online:
23 November 2021

© 2021. Thieme. All rights reserved.

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