Intestinal microbiota and anastomotic leakage of stapled colorectal anastomoses: a pilot study

Abstract

Background Anastomotic leakage (AL) after colorectal surgery is a severe complication, resulting in morbidity, reinterventions, prolonged hospital stay and, in some cases, death. Some technical and patient-related aetiological factors of AL are well established. In many cases, however, none of these factors seem to explain the occurrence of AL. Recent studies suggest that the intestinal microbiome plays a role in wound healing, diabetes and Crohn’s disease. The aim of this study was to compare the intestinal microbiota of patients who developed AL with matched patients with healed colorectal anastomoses.MethodsWe investigated the microbiome in the doughnuts collected from 16 patients participating in the C-seal trial. We selected eight patients who developed AL requiring reintervention and eight matched controls without AL. We analysed the bacterial 16S rDNA of both groups with MiSeq sequencing.ResultsThe abundance of Lachnospiraceae is statistically higher (P = 0.001) in patient group who did develop AL, while microbial diversity levels were higher in the group who did not develop AL (P = 0.037). Body mass index (BMI) was also positively associated with the abundance of the Lachnospiraceae family (P = 0.022).ConclusionA correlation between the bacterial family Lachnospiraceae, low microbial diversity and anastomotic leakage, possibly in association with the BMI, was found. The relative abundance of the Lachnospiraceae family is possibly explained by the higher abundance of mucin-degrading Ruminococci within that family in AL cases (P = 0.011) as is similarly the case in IBD. Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-015-4508-z) contains supplementary material, which is available to authorized users.

Targeted Diet Modification Reduces Multiple Sclerosis–like Disease in Adult Marmoset Monkeys from an Outbred Colony

“…The extracted DNA was amplified and processed as previously described (27). Briefly, primers covering the V3 and V4 hyper V region of the bacterial 16S rRNA genes were used.…”

Gut microbiome, surgical complications and probiotics

“…The microbiome of eight patients who experienced colorectal anastomotic rupture and of another eight matched for age, gender and adjuvant therapy, was investigated by studying the rings of colon and rectum tissues cut by the circular stapler to make the anastomosis [62]. The investigators surprisingly reported a significantly higher proportion of the Lachnospiraceae family versus controls-although these bacteria tend to be rather friendly to the bowel, as most of them belong to butyrate producing genera.…”

Novel insight into the role of microbiota in colorectal surgery

“…The C-seal is a biodegradable sheath that protects the stapled colorectal anastomosis from leakage 101. The researchers compared the mucosa-associated microbiota collected at the anastomosis level during the surgical intervention from eight patients who developed AL requiring reintervention with that of matched individuals from the same trial who had a favourable evolution 102. They found a correlation between the bacterial family Lachnospiraceae , low microbial diversity and AL, possibly in association with the body mass index.…”