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Improving the Outcome of Stoma Reversal Surgery: Impact of Microflora
Author(s) -
Beamish Emma,
Pattisson Charlotte,
Johnson Judith,
Scott Nigel,
Bhowmick Arnab,
Stagg Andrew,
Rigby Rachael
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.853.1
Subject(s) - stoma (medicine) , dysbiosis , colorectal cancer , medicine , gastroenterology , mesorectum , intestinal mucosa , pathology , cancer , biology , surgery , disease , total mesorectal excision
Patients who develop colorectal cancer or chronic colitis often require surgical gut resection. To facilitate healing a temporary redirection of luminal contents, via stoma formation upstream of the surgical site, is often used. Reanastamosis of the stoma at a later date reinstates luminal flow through the entire intestine. Stoma reversal is associated with post‐operative complications and therefore a proportion of patients (~20%) experience a reduced quality of life and ~5% of cases prove to be irreversible. Our research aims to investigate the pathological consequences of stoma formation. Functional and defunctioned limbs were compared using histological, flow cytometric, 16s rDNA PCR‐DGGE and qPCR techniques, to assess morphology, immune and microbial populations respectively. Histological examination revealed villous atrophy in the defunctioned limb but no significant difference in overall inflammation score, indicating that severe immunopathology was not contributing to intestinal changes. However, a shift the in the distribution of inflammatory macrophages in the mucosa of defunctioned vs. functional bowel suggests immunological dysregulation. DGGE and qPCR analyses of major bacterial Phyla revealed variations in microbial profiles between the functional and defunctioned intestinal limbs, suggesting that stoma‐associated nutrient deprivation results in intestinal dysbiosis. This data may provide a rationale for the use of prebiotic preparations to sustain intestinal microbes, to maintain mucosal homeostasis and improve the success of stoma reversal surgery. Bowel Cancer Research