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Tytuł pozycji:

The gut microbiota and colorectal surgery outcomes: facts or hype? A narrative review.

Tytuł :
The gut microbiota and colorectal surgery outcomes: facts or hype? A narrative review.
Autorzy :
Agnes A; Università Cattolica del Sacro Cuore, Largo F. Vito n.1, 00168, Rome, Italy.; Dipartimento Di Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli n. 8, 00168, Rome, Italy.
Puccioni C; Università Cattolica del Sacro Cuore, Largo F. Vito n.1, 00168, Rome, Italy.
D'Ugo D; Università Cattolica del Sacro Cuore, Largo F. Vito n.1, 00168, Rome, Italy.; Dipartimento Di Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli n. 8, 00168, Rome, Italy.
Gasbarrini A; Università Cattolica del Sacro Cuore, Largo F. Vito n.1, 00168, Rome, Italy.; Dipartimento Di Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli n. 8, 00168, Rome, Italy.
Biondi A; Università Cattolica del Sacro Cuore, Largo F. Vito n.1, 00168, Rome, Italy. .; Dipartimento Di Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli n. 8, 00168, Rome, Italy. .
Persiani R; Università Cattolica del Sacro Cuore, Largo F. Vito n.1, 00168, Rome, Italy.; Dipartimento Di Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli n. 8, 00168, Rome, Italy.
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Źródło :
BMC surgery [BMC Surg] 2021 Feb 12; Vol. 21 (1), pp. 83. Date of Electronic Publication: 2021 Feb 12.
Typ publikacji :
Journal Article; Review
Język :
English
Imprint Name(s) :
Original Publication: London : BioMed Central, [2001-
MeSH Terms :
Colorectal Surgery*
Enhanced Recovery After Surgery*
Gastrointestinal Microbiome*
Probiotics*
Anastomotic Leak/*prevention & control
Anti-Bacterial Agents/*administration & dosage
Colonic Diseases/*surgery
Digestive System Surgical Procedures/*adverse effects
Preoperative Care/*methods
Surgical Wound Infection/*prevention & control
Antibiotic Prophylaxis ; Colonic Diseases/complications ; Colonic Diseases/pathology ; Elective Surgical Procedures/adverse effects ; Humans ; Postoperative Complications ; Surgical Wound Infection/drug therapy
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Contributed Indexing :
Keywords: Microbiota; colorectal surgery; anastomotic leak; Oral antibiotic preparation; Surgical site infections
Substance Nomenclature :
0 (Anti-Bacterial Agents)
Entry Date(s) :
Date Created: 20210213 Date Completed: 20210217 Latest Revision: 20210218
Update Code :
20210218
PubMed Central ID :
PMC7881582
DOI :
10.1186/s12893-021-01087-5
PMID :
33579260
Czasopismo naukowe
Background: The gut microbiota (GM) has been proposed as one of the main determinants of colorectal surgery complications and theorized as the "missing factor" that could explain still poorly understood complications. Herein, we investigate this theory and report the current evidence on the role of the GM in colorectal surgery.
Methods: We first present the findings associating the role of the GM with the physiological response to surgery. Second, the change in GM composition during and after surgery and its association with colorectal surgery complications (ileus, adhesions, surgical-site infections, anastomotic leak, and diversion colitis) are reviewed. Finally, we present the findings linking GM science to the application of the enhanced recovery after surgery (ERAS) protocol, for the use of oral antibiotics with mechanical bowel preparation and for the administration of probiotics/synbiotics.
Results: According to preclinical and translational evidence, the GM is capable of influencing colorectal surgery outcomes. Clinical evidence supports the application of an ERAS protocol and the preoperative administration of multistrain probiotics/synbiotics. GM manipulation with oral antibiotics with mechanical bowel preparation still has uncertain benefits in right-sided colic resection but is very promising for left-sided colic resection.
Conclusions: The GM may be a determinant of colorectal surgery outcomes. There is an emerging need to implement translational research on the topic. Future clinical studies should clarify the composition of preoperative and postoperative GM and the impact of the GM on different colorectal surgery complications and should assess the validity of GM-targeted measures in effectively reducing complications for all colorectal surgery locations.

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