Jasper B van Praagh1, Marcus C de Goffau2,3, Ilsalien S Bakker1,4, Harry van Goor5, Hermie J M Harmsen2, Peter Olinga6, Klaas Havenga1. 1. Department of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. 2. Department of Medical Microbiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. 3. Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, United Kingdom. 4. Department of Surgery, Treant Zorggroep, Emmen, The Netherlands. 5. Department of Pathology and Medical Biology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. 6. Pharmaceutical Technology and Biopharmacy, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
Abstract
OBJECTIVE: The aim of the present study is to investigate the association of gut microbiota, depending on treatment method, with the development of colorectal anastomotic leakage (AL). BACKGROUND: AL is a major cause for morbidity and mortality after colorectal surgery, but the mechanism behind this complication still is not fully understood. METHODS: Bacterial DNA was isolated from 123 "donuts" of patients where a stapled colorectal anastomosis was made and was analyzed using 16S MiSeq sequencing. In 63 patients, this anastomosis was covered with a C-seal, a bioresorbable sheath stapled to the anastomosis. RESULTS: In non-C-seal patients, AL development was associated with low microbial diversity (P = 0.002) and correspondingly with a high abundance of the dominant Bacteroidaceae and Lachnospiraceae families (P = 0.008 and 0.010, respectively). In C-seal samples, where AL rates were slightly higher (25% vs 17%), an association with the gut microbiota composition was almost undetectable. Only a few opportunistic pathogenic groups of low abundance were associated with AL in C-seal patients, in particular Prevotella oralis (P = 0.007). CONCLUSIONS: AL in patients without a C-seal can be linked to the intestinal microbiota, in particular with a low microbial diversity and a higher abundance of especially mucin-degrading members of the Bacteroidaceae and Lachnospiraceae families. In C-seal patients, however, it seems that any potential protective benefits or harmful consequences of the gut microbiota composition in regard to wound healing are negated, as progression to AL is independent of the initially dominant bacterial composition.
OBJECTIVE: The aim of the present study is to investigate the association of gut microbiota, depending on treatment method, with the development of colorectal anastomotic leakage (AL). BACKGROUND: AL is a major cause for morbidity and mortality after colorectal surgery, but the mechanism behind this complication still is not fully understood. METHODS: Bacterial DNA was isolated from 123 "donuts" of patients where a stapled colorectal anastomosis was made and was analyzed using 16S MiSeq sequencing. In 63 patients, this anastomosis was covered with a C-seal, a bioresorbable sheath stapled to the anastomosis. RESULTS: In non-C-sealpatients, AL development was associated with low microbial diversity (P = 0.002) and correspondingly with a high abundance of the dominant Bacteroidaceae and Lachnospiraceae families (P = 0.008 and 0.010, respectively). In C-seal samples, where AL rates were slightly higher (25% vs 17%), an association with the gut microbiota composition was almost undetectable. Only a few opportunistic pathogenic groups of low abundance were associated with AL in C-sealpatients, in particular Prevotella oralis (P = 0.007). CONCLUSIONS: AL in patients without a C-seal can be linked to the intestinal microbiota, in particular with a low microbial diversity and a higher abundance of especially mucin-degrading members of the Bacteroidaceae and Lachnospiraceae families. In C-sealpatients, however, it seems that any potential protective benefits or harmful consequences of the gut microbiota composition in regard to wound healing are negated, as progression to AL is independent of the initially dominant bacterial composition.
Authors: Miquell O Miller; Purna C Kashyap; Sarah L Becker; Ryan M Thomas; Richard A Hodin; George Miller; Mautin Hundeyin; Smruti Pushalkar; Deirdre Cohen; Deepak Saxena; Benjamin D Shogan; Gareth J Morris-Stiff Journal: J Gastrointest Surg Date: 2021-07 Impact factor: 3.452
Authors: Antonio Sciuto; Giovanni Merola; Giovanni D De Palma; Maurizio Sodo; Felice Pirozzi; Umberto M Bracale; Umberto Bracale Journal: World J Gastroenterol Date: 2018-06-07 Impact factor: 5.742
Authors: Karolina Kaźmierczak-Siedlecka; Agnieszka Daca; Mateusz Fic; Thierry van de Wetering; Marcin Folwarski; Wojciech Makarewicz Journal: Gut Microbes Date: 2020-05-26