Complications after colorectal surgery

In Denmark, 4,000 patients undergo surgery for cancer of the colon or rectum every year. Around 30% of patients suffer complications after the operation. One of the most serious is anastomotic leakage. It often necessitates an acute operation, in which an ostomy is constructed, resulting in a longer stay in hospital (with a period in the ICU), as well as increased costs, poorer quality of life, relapse of malignant disease and increased risk of death. This complication occurs in between 5-10% of cases. It depends on the area of the intestine where the anastomosis is located.

 

The healing of the anastomosis depends on the formation of new connective tissue. Some intestinal bacteria produce enzymes which break down the connective tissue, and this is the basis for a hypothesis that these intestinal bacteria have a negative effect on the healing process and cause a leak in the anastomosis.

 

“We are very glad that the Vissing Foundation is supporting our research project. We will examine the stools from patients who have suffered an anastomotic leakage after an operation for colorectal cancer. We will compare these stools samples with samples from another group of patients who have not had anastomotic leakage. We want to understand this serious complication better, and hope that in the longer term we can reduce the risk of it occurring,” says Anders Bech Jørgensen, senior house officer and PhD student, Holbæk Hospital Department of Surgery.

 

Impact of the gut microbiome on anastomotic leakage after colorectal surgery

In Denmark, approximately 4,000 operations are performed each year for cancer of the colon or rectum. In addition to this comes surgery for benign disorders of the same organs.

 

Up to 30% of patients develop complications after the operation, and one of the most serious is anastomotic leakage, which often requires emergency surgery with construction of an ostomy, increased length of admission (with an intensive care unit stay), increased costs, reduced quality of life, relapse of malignant disease and increased risk of death.

The incidence of this complication is between 5-10%, depending on which part of the intestine the anastomosis is located on.

 

The healing of the anastomosis requires formation of new connective tissue (collagen). Some intestinal bacteria can produce enzymes (collagenase), which break down collagen.

 

This leads to a hypothesis that these intestinal bacteria help to promote this unwanted process.

The aim of the project is to examine stool samples from patients who have previously had surgery and subsequently had anastomotic leakage. By comparing stool samples from a similar group of patients, who did not have anastomotic leakage after surgery, we can gain a better understanding of this serious complication, and perhaps in the long run reduce the risk of it occurring