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Open Access 01-12-2017 | Research article

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

Authors: Ann-Kathrin Lederer, Przemyslaw Pisarski, Lampros Kousoulas, Stefan Fichtner-Feigl, Carolin Hess, Roman Huber

Published in: BMC Surgery | Issue 1/2017

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.

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Title: Postoperative changes of the microbiome: are surgical complications related to the gut flora? A systematic review
Authors: Ann-Kathrin Lederer
Przemyslaw Pisarski
Lampros Kousoulas
Stefan Fichtner-Feigl
Carolin Hess
Roman Huber
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Surgery / Issue 1/2017
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-017-0325-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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