About this Research Topic
This is a continuation of the Research Topic on "Anastomotic and Intestinal Wound Healing: Recent advances and future directions". Intestinal wound healing is extremely important to prevent anastomotic leakage after colorectal surgery. The process of intestinal mucosal wound repair is orchestrated by highly regulated events that involve the epithelium, recruited immune cells, resident stromal cells, and the microbiota. An impaired regeneration of intestinal barrier can result in intestinal inflammation causing systemic inflammation and septic complications. Even if surgical techniques and peri-operative medicine have further improved in the last decades, leakage of gastrointestinal anastomosis is still a severe complication accompanied with significant increase of morbidity and mortality.
The common surgical dogma blames ischemia, tension, and device failure for the occurrence of postoperative anastomotic leakage. Furthermore, patient´s characteristics such as obesity, immunosuppression, and diabetes mellitus are widely described risk factors for impaired intestinal healing. In the last years, several studies have been published showing new ideas and approaches to overcome the old surgical dogma of anastomotic wound healing including the role of the mesentery, new surgical anastomotic techniques, and the influence of patient´s microbiota. For example, there is a growing body of new evidence postulating that due to the release of stress factors by the host, the phenotype of intestinal microbiota changes with increased expression and activity of collagenases resulting in postoperative anastomotic leakage.
However, the pathophysiology of anastomotic leakage after colorectal surgery is still not well understood yet, and further research and studies are urgently needed to better understand the (patho-)physiology of intestinal wound and anastomotic healing to improve clinical outcome of patients after colorectal surgery.
The aim of this research topic is to address all the challenges mentioned above. We highly welcome all types of manuscripts except case reports that provide novel ideas and approaches in basic and clinical research, evidence about new surgical techniques and perioperative pathways and strategies to prevent anastomotic leakage.
The common surgical dogma blames ischemia, tension, and device failure for the occurrence of postoperative anastomotic leakage. Furthermore, patient´s characteristics such as obesity, immunosuppression, and diabetes mellitus are widely described risk factors for impaired intestinal healing. In the last years, several studies have been published showing new ideas and approaches to overcome the old surgical dogma of anastomotic wound healing including the role of the mesentery, new surgical anastomotic techniques, and the influence of patient´s microbiota. For example, there is a growing body of new evidence postulating that due to the release of stress factors by the host, the phenotype of intestinal microbiota changes with increased expression and activity of collagenases resulting in postoperative anastomotic leakage.
However, the pathophysiology of anastomotic leakage after colorectal surgery is still not well understood yet, and further research and studies are urgently needed to better understand the (patho-)physiology of intestinal wound and anastomotic healing to improve clinical outcome of patients after colorectal surgery.
The aim of this research topic is to address all the challenges mentioned above. We highly welcome all types of manuscripts except case reports that provide novel ideas and approaches in basic and clinical research, evidence about new surgical techniques and perioperative pathways and strategies to prevent anastomotic leakage.
Keywords: Intestinal Wound Healing, Anastomotic Healing, Anastomotic Leakage, Microbiota, Microbiome, Mesentery
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