Ricerc@Sapienza

Despite improvements in surgical technique and postoperative surveillance, colorectal anastomotic leaks and cancer recurrence after pathologically confirmed complete surgical resection remain a significant issue.
Only recently we have begun to acknowledge the importance of microbial organisms and our symbiotic relationship which allows for our survival and health maintenance.
It has been proposed that factors unrelated to the technical characteristics of the anastomosis may contribute to the development of anastomotic leaks. Furthermore, there is evidence demonstrating that anastomotic leaks are associated with increased local recurrence and reduced disease-free survival in patients with colorectal cancer.
One of the factors that has been scarcely investigated is certainly the gut micriobiome. To this regard, some authors have shown in experimental conditions, how microbiota has a strong influence on the healing process of an intestinal anastomosis. Understanding the mechanisms by which the bacterial community of the gut influences intestinal healing and cancer recurrence process could open the door for new preventive and therapeutic approaches. There is an urgent need for appropriate interventions with a deep microbiota analysis to determine both the surgical technical benefits of a proper anastomosis compared with the potential effect of the gut microbes (beneficial vs harmful) on the processes of wound healing, anastomotic leakage reduction and possible cancer recurrence.
Interrogating the intestinal microbiome using next-generation sequencing technology has the potential to directly and indirectly influence cancer outcomes following colonic resection. The aim of this study is to compare the intestinal microbiota of patients who developed anastomotic leaks and/or local cancer recurrence with matched patients with correctly healed colorectal anastomoses without local recurrence.