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. 2017 Dec 4;17(1):125.
doi: 10.1186/s12893-017-0325-8.

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

Ann-Kathrin Lederer  1 , Przemyslaw Pisarski  2 , Lampros Kousoulas  2 , Stefan Fichtner-Feigl  2 , Carolin Hess  3 , Roman Huber  4
Affiliations

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

Ann-Kathrin Lederer et al. BMC Surg. .

Abstract

Background: The 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.

Methods: In 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.

Results: Of 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.

Conclusions: There 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.

Keywords: Anastomotic leakage; Gastrointestinal microbiome; Microbiota; Postoperative complications; Surgical wound infection.

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Conflict of interest statement

Ethics approval and consent to participate

The manuscript is based on data, which was generated by other research groups. All of the included studies were approved by their local ethical committee.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Process of screening and selection
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