Alterations of the Rectal Microbiome Are Associated with the Development of Postoperative Ileus in Patients Undergoing Colorectal Surgery View Full Text


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Article Info

DATE

2020-04-22

AUTHORS

Benjamin D. Shogan, Jun Chen, Emilie Duchalais, Danielle Collins, Melissa Chang, Kimberly Krull, Monika A. Krezalek, David W. Larson, Marina R. Walther-Antonio, Nicholas Chia, Heidi Nelson

ABSTRACT

BackgroundThe most common complications after colorectal surgery, postoperative ileus, surgical site infections, and anastomotic leaks continue to occur despite advances in surgical technique and enhanced recovery pathways. Preclinical studies have documented that intestinal bacteria play a role in the development of these complication, yet human data is lacking. Here we hypothesized that patients that develop ileus, surgical site infection, and/or anastomotic leak following colorectal surgery harbor a specific preoperative gut microbiome.MethodsWe performed a prospective cohort study on 101 patients undergoing colon or rectal resection at the Mayo Clinic. Rectal samples were collected preoperatively and on the ward on postoperative day two. The bacterial community from each sample was characterized by 16S rRNA and associated with the development of complications.ResultsThe rectal microbiome collected from patients in the operating room (p = .003) and on postoperative day two (p = .001) was significantly difference in patients whom later developed postoperative ileus compared with patients that had a normal return of bowel function. Patients whom developed ileus showed increased abundance of Bacteroides spp., Parabacteroides spp., and Ruminococcus spp., bacteria that are associated with promoting intestinal inflammation. There were no differences in the microbiome in patients that developed surgical site infections or anastomotic leaks.ConclusionsIn this pilot study, patients that develop postoperative ileus harbor a specific gut microbiome during the perioperative period. These findings demonstrate that the preoperative bacterial composition may predispose patients to the development of ileus and that perioperative manipulation of the gut bacteria may provide a novel method to promote normal return of bowel function. More... »

PAGES

1663-1672

References to SciGraph publications

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  • 2014-10-10. Oral Antibiotic Treatment Induces Skin Microbiota Dysbiosis and Influences Wound Healing in MICROBIAL ECOLOGY
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    27 schema:description BackgroundThe most common complications after colorectal surgery, postoperative ileus, surgical site infections, and anastomotic leaks continue to occur despite advances in surgical technique and enhanced recovery pathways. Preclinical studies have documented that intestinal bacteria play a role in the development of these complication, yet human data is lacking. Here we hypothesized that patients that develop ileus, surgical site infection, and/or anastomotic leak following colorectal surgery harbor a specific preoperative gut microbiome.MethodsWe performed a prospective cohort study on 101 patients undergoing colon or rectal resection at the Mayo Clinic. Rectal samples were collected preoperatively and on the ward on postoperative day two. The bacterial community from each sample was characterized by 16S rRNA and associated with the development of complications.ResultsThe rectal microbiome collected from patients in the operating room (p = .003) and on postoperative day two (p = .001) was significantly difference in patients whom later developed postoperative ileus compared with patients that had a normal return of bowel function. Patients whom developed ileus showed increased abundance of Bacteroides spp., Parabacteroides spp., and Ruminococcus spp., bacteria that are associated with promoting intestinal inflammation. There were no differences in the microbiome in patients that developed surgical site infections or anastomotic leaks.ConclusionsIn this pilot study, patients that develop postoperative ileus harbor a specific gut microbiome during the perioperative period. These findings demonstrate that the preoperative bacterial composition may predispose patients to the development of ileus and that perioperative manipulation of the gut bacteria may provide a novel method to promote normal return of bowel function.
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    35 Mayo Clinic
    36 MethodsWe
    37 Parabacteroides spp
    38 Ruminococcus spp
    39 abundance
    40 advances
    41 alterations
    42 anastomotic leak
    43 bacteria
    44 bacterial communities
    45 bacterial composition
    46 bowel function
    47 clinic
    48 cohort study
    49 colon
    50 colorectal surgery
    51 common complication
    52 community
    53 complications
    54 composition
    55 data
    56 day two
    57 development
    58 development of complications
    59 development of ileus
    60 differences
    61 findings
    62 function
    63 gut bacteria
    64 gut microbiome
    65 human data
    66 ileus
    67 infection
    68 inflammation
    69 intestinal bacteria
    70 intestinal inflammation
    71 leak
    72 manipulation
    73 method
    74 microbiome
    75 normal returns
    76 novel method
    77 operating room
    78 pathway
    79 patients
    80 period
    81 perioperative manipulation
    82 perioperative period
    83 pilot study
    84 postoperative day two
    85 postoperative ileus
    86 preclinical studies
    87 prospective cohort study
    88 rRNA
    89 recovery pathways
    90 rectal microbiome
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    92 rectal samples
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    108 schema:name Alterations of the Rectal Microbiome Are Associated with the Development of Postoperative Ileus in Patients Undergoing Colorectal Surgery
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