Postoperative changes of the microbiome: are surgical complications related to the gut flora? A systematic review

BMC Surgery

Research Article

Roman Huber¹  Ann-Kathrin Lederer¹  Przemyslaw Pisarski²  Lampros Kousoulas²  Stefan Fichtner-Feigl²  Carolin Hess³ 

[1] Center for Complementary Medicine, Department of Environmental Health Sciences and Hospital Infection Control, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 115b, 79106, Freiburg im Breisgau, Germany;Department for General and Visceral Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany;Department for Thoracic Surgery, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany;

关键词: Microbiota;    Gastrointestinal microbiome;    Postoperative complications;    Anastomotic leakage;    Surgical wound infection;   

DOI  :  10.1186/s12893-017-0325-8

 received in 2017-08-07, accepted in 2017-11-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe purpose of this review was to identify the relationship between the gut microbiome and the development of postoperative complications like anastomotic leakage or a wound infection. Recent reviews focusing on underlying molecular biology suggested that postoperative complications might be influenced by the patients’ gut flora. Therefore, a review focusing on the available clinical data is needed.MethodsIn January 2017 a systematic search was carried out in Medline and WebOfScience to identify all clinical studies, which investigated postoperative complications after gastrointestinal surgery in relation to the microbiome of the gut.ResultsOf 337 results 10 studies were included into this analysis after checking for eligibility. In total, the studies comprised 677 patients. All studies reported a postoperative change of the gut flora. In five studies the amount of bacteria decreased to different degrees after surgery, but only one study found a significant reduction. Surgical procedures tended to result in an increase of potentially pathogenic bacteria and a decrease of Lactobacilli and Bifidobacteria. The rate of infectious complications was lower in patients treated with probiotics/symbiotics compared to control groups without a clear relation to the systemic inflammatory response. The treatment with synbiotics/probiotics in addition resulted in faster recovery of bowel movement and a lower rate of postoperative diarrhea and abdominal cramping.ConclusionsThere might be a relationship between the gut flora and the development of postoperative complications. Due to methodological shortcomings of the included studies and uncontrolled bias/confounding factors there remains a high level of uncertainty.

【 授权许可】

CC BY   
© The Author(s). 2017