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 9th, 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 fuid was presented. In 10 of the 15 studies, one or more collagenase-producing
bacteria were identifed in the patients with AL. Neither the bacteria nor the collagenase production were quantifed 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 fndings 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 signifcance is unclear. From the current studies, it is not possible to determine the pathogenicity of the individual gut bacteria.
Keywords Anastomotic leakage · Colorectal surgery · Bacterial collagenase · Gut microbiome · Complications
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 9th, 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 fuid was presented. In 10 of the 15 studies, one or more collagenase-producing
bacteria were identifed in the patients with AL. Neither the bacteria nor the collagenase production were quantifed 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 fndings 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 signifcance is unclear. From the current studies, it is not possible to determine the pathogenicity of the individual gut bacteria.
Keywords Anastomotic leakage · Colorectal surgery · Bacterial collagenase · Gut microbiome · Complications
| Bidragets oversatte titel | Kollagenaseproducerende bakterier er almindelige ved anastomoselækage efter kolorektal kirurgi: En systematisk litteraturgennemgang |
|---|---|
| Originalsprog | Engelsk |
| Artikelnummer | 275 |
| Antal sider | 13 |
| Tidsskrift | International Journal of Colorectal Disease |
| Vol/bind | 38 |
| Udgave nummer | 1 |
| DOI | |
| Status | Udgivet - 1 dec. 2023 |
Finansiering
| Bevillingsgivere |
|---|
| Holbæk Sygehus |
| Region Sjælland |
| Dagmar Marshalls Fond |
| Danish Cancer Society |