Journal article
Patient Acceptance of Routine Serial Postoperative Endoscopy Following Low Anterior Resection (LAR) and Its Ability to Detect Biomarkers in Anastomotic Lavage Fluid
World journal of surgery, Vol.45(7), pp.2227-2234
07/01/2021
DOI: 10.1007/s00268-021-06062-y
PMCID: PMC8516158
PMID: 33742231
Abstract
Background Various reports have now established that postoperative endoscopy to examine and intervene in the process of anastomotic healing is both feasible and safe. Here we present our preliminary experience with serial postoperative endoscopy to determine its feasibility, patient acceptance and the ability to obtain and the utility of perianastomotic material for molecular analysis. Methods Patients undergoing LAR with ileostomy for rectal cancer were recruited for study to undergo routine serial endoscopic surveillance (SES) at three time points during the course of LAR: intraoperatively, before discharge (postoperative day 3-7) and at follow-up (postoperative day 10-28). At each endoscopy, images were captured, anastomotic tissues were lavaged and lavage fluid was retrieved. Fluid samples were analyzed using proteomics, zymography, ELISA and bacteria via 16S rRNA gene amplicon sequencing and culture of collagenolytic strains. Results SES is feasible and acceptable to this limited set of patients following LAR. Biologic analysis of perianastomotic fluids was able to detect the presence of proteins, microbiota and inflammatory mediators previously identified at anastomotic sites in animals with pathologic healing. Conclusion SES can be implemented in patients undergoing LAR with a high degree of patient compliance and capture of biologic information and imaging. Application of this approach has the potential to uncover, for the first time, the natural history of normal versus pathologic anastomotic healing in patients undergoing anastomotic surgery.
Details
- Title: Subtitle
- Patient Acceptance of Routine Serial Postoperative Endoscopy Following Low Anterior Resection (LAR) and Its Ability to Detect Biomarkers in Anastomotic Lavage Fluid
- Creators
- Kristina Guyton - University of ChicagoNatalia Belogortseva - University of ChicagoZoe Levine - University of ChicagoBrooke Deatherage Kaiser - Pacific Northwest Natl Lab, Richland, WA USANaseer Sangwan - Cleveland ClinicNeil Hyman - University of ChicagoBenjamin D. Shogan - University of ChicagoOlga Zaborina - University of ChicagoJohn C. Alverdy - University of Chicago
- Resource Type
- Journal article
- Publication Details
- World journal of surgery, Vol.45(7), pp.2227-2234
- DOI
- 10.1007/s00268-021-06062-y
- PMID
- 33742231
- PMCID
- PMC8516158
- NLM abbreviation
- World J Surg
- ISSN
- 0364-2313
- eISSN
- 1432-2323
- Publisher
- Springer Nature
- Number of pages
- 8
- Grant note
- GM103493 / NIH National Institute of General Medical Sciences; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of General Medical Sciences (NIGMS) W.R. Wiley Environmental Molecular Science Laboratory - U.S. Department of Energy's Office of Biological and Environmental Research DE-AC05-76RLO-1830 / U.S. Department of Energy; United States Department of Energy (DOE) LPG-098 / American Society of Colon and Rectal Surgeons Research Foundation
- Language
- English
- Date published
- 07/01/2021
- Academic Unit
- Surgery
- Record Identifier
- 9984322935202771
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