Why the study?
Despite advances in surgery and imaging, anastomotic leakage remains a major complication with high incidence and mortality after intestinal surgery.
This review highlights the multifactorial causes of anastomotic leakage in colorectal surgery and emphasizes the importance of preoperative nutritional adjustment and intraoperative protective stomas to reduce its incidence.
Microbiota changes may contribute to anastomotic leakage; leaves open whether modulation improves outcomes.
Despite the considerable progress in surgical level and imaging examination methods, anastomotic leakage is still the major complication after intestinal surgery with high incidence rate and mortality rate. Moreover, anastomotic leakage has become one of the serious complications threatening the postoperative life safety, prognosis and quality of life. The occurrence of anastomotic leakage involves the changes of a variety of pathophysiological factors, and is affected by intestinal microbiota, inflammation and immune system. Preoperative intestinal preparation will change the type and number of microbial population in the intestine. Intraoperative anastomotic mode and bleeding volume are also closely related to the occurrence of anastomotic leakage. In addition, the occurrence of anastomotic leakage is associated with local recurrence of colorectal cancer after surgery. Intraoperative protective stoma is confirmed to reduce the incidence of anastomotic leakage. Combined preoperative adjustment of nutritional status and inflammatory factors is important for avoiding anastomotic leakage after surgery.
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Yu et al. (2021) studied this question.
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