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International Journal of Colorectal Disease

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Open Access 01-12-2023 | Rectal Extirpation | REVIEW

Collagenase-producing bacteria are common in anastomotic leakage after colorectal surgery: a systematic review

Authors: Anders Bech Jørgensen, Isabella Jonsson, Lennart Friis-Hansen, Birgitte Brandstrup

Published in: International Journal of Colorectal Disease | Issue 1/2023

Abstract

Purpose

Some gut bacteria can produce enzymes (collagenases) that can break down collagen in the intestinal wall. This could be a part of the pathophysiology of anastomotic leakage (AL). This systematic review aimed to investigate if such bacteria were present more frequently in AL patients versus non-AL patients following colorectal surgery.

Methods

This systematic review was reported according to the PRISMA and AMSTAR guidelines. Before the literature search, a study protocol was registered at PROSPERO (CRD42022363454). We searched PubMed, EMBASE, Google Scholar, and Cochrane CENTRAL on April 9^th, 2023, for randomized and observational human studies of AL following colorectal surgery with information on gastrointestinal bacteria. The primary outcome was bacteria with the potential to produce collagenase. The risk of bias was assessed with the Newcastle–Ottawa Scale, as all studies were observational.

Results

We included 15 studies, with a total of 52,945 patients, of which 1,747 had AL, and bacteriological information from feces, mucosa, the resected specimen, or drain fluid was presented. In 10 of the 15 studies, one or more collagenase-producing bacteria were identified in the patients with AL. Neither the bacteria nor the collagenase production were quantified in any of the studies. The studies varied greatly in terms of sample material, analytical method, and time of collection. Studies using DNA sequencing methods did not report findings of collagenase-producing bacteria.

Conclusion

Collagenase-producing bacteria are more common in patients with AL following colorectal surgery than in patients without AL, but the significance is unclear. From the current studies, it is not possible to determine the pathogenicity of the individual gut bacteria.

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Title: Collagenase-producing bacteria are common in anastomotic leakage after colorectal surgery: a systematic review
Authors: Anders Bech Jørgensen
Isabella Jonsson
Lennart Friis-Hansen
Birgitte Brandstrup
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Rectal Extirpation
Rectal Extirpation
Published in: International Journal of Colorectal Disease / Issue 1/2023
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-023-04562-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Collagenase-producing bacteria are common in anastomotic leakage after colorectal surgery: a systematic review

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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