Department of General Surgery, Xuchang Central Hospital, Xuchang City, Henan Province, China.
Medicine (Baltimore). 2022 Jul 22;101(29):e29826. doi: 10.1097/MD.0000000000029826.
Gastrointestinal surgery is often challenging because of unexpected postoperative complications such as pouchitis, malabsorption, anastomotic leak, diarrhea, inflammatory responses, and life-threatening infections. Moreover, the gut microbiota has been shown to be associated with the complications described above. Major intestinal reconstruction, such as Roux-en-Y gastric bypass (RYGB) and ileal pouch-anal anastomosis surgery, could result in altered gut microbiota, which might lead to some of the benefits of these procedures but could also contribute to the development of postsurgical complications. Moreover, postsurgical reestablishment of the gut microbiota population is still poorly understood. Here, we review evidence outlining the role of gut microbiota in complications of gastrointestinal surgery, especially malabsorption, anastomotic leak, pouchitis, and infections. In addition, this review will evaluate the risks and benefits of live biotherapeutics in the complications of gastrointestinal surgery.
胃肠外科手术常常面临挑战,因为术后可能出现各种并发症,如袋炎、吸收不良、吻合口漏、腹泻、炎症反应和危及生命的感染。此外,肠道微生物群与上述并发症有关。例如 Roux-en-Y 胃旁路术(RYGB)和回肠储袋肛管吻合术等主要肠道重建手术可能导致肠道微生物群发生改变,这可能是这些手术获益的原因之一,但也可能导致术后并发症的发生。此外,术后肠道微生物群的重建仍知之甚少。本文综述了肠道微生物群在胃肠外科手术并发症(尤其是吸收不良、吻合口漏、袋炎和感染)中的作用证据。此外,本文还将评估胃肠道手术并发症中使用活体生物治疗的风险和获益。