Doudakmanis C, Bouliaris K, Kolla C, Efthimiou M, Koukoulis GD. Bacterial translocation in patients undergoing major gastrointestinal surgery and its role in postoperative sepsis. World J Gastrointest Pathophysiol 2021; 12(6): 106-114 [PMID: 34877025 DOI: 10.4291/wjgp.v12.i6.106]
Corresponding Author of This Article
Georgios D Koukoulis, MD, MSc, PhD, Adjunct Professor, Doctor, Surgeon, Department of General Surgery, General Hospital of Larissa, Tsakalof 1, Larisa 41221, Greece. georgios.koukoulis@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pathophysiol. Nov 22, 2021; 12(6): 106-114 Published online Nov 22, 2021. doi: 10.4291/wjgp.v12.i6.106
Bacterial translocation in patients undergoing major gastrointestinal surgery and its role in postoperative sepsis
Christos Doudakmanis, Konstantinos Bouliaris, Christina Kolla, Matthaios Efthimiou, Georgios D Koukoulis
Christos Doudakmanis, Konstantinos Bouliaris, Christina Kolla, Matthaios Efthimiou, Georgios D Koukoulis, Department of General Surgery, General Hospital of Larissa, Larisa 41221, Greece
Author contributions: Koukoulis GD and Doudakmanis C were responsible for conception and design of the study and acquisition of the data; Bouliaris K and Doudakmanis C were responsible for analysis and interpretation of the data; Doudakmanis C, Bouliaris K, Koukoulis GD, Kolla C, and Efthimiou M were responsible for drafting of the article; Efthimiou M was responsible for critical revision of the manuscript for important intellectual content; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: Christos Doudakmanis, Konstantinos Bouliaris, Christina Kolla, Matthaios Efthimiou, and Georgios D Koukoulis declare that they have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Georgios D Koukoulis, MD, MSc, PhD, Adjunct Professor, Doctor, Surgeon, Department of General Surgery, General Hospital of Larissa, Tsakalof 1, Larisa 41221, Greece. georgios.koukoulis@gmail.com
Received: March 16, 2021 Peer-review started: March 16, 2021 First decision: May 6, 2021 Revised: May 14, 2021 Accepted: September 14, 2021 Article in press: September 14, 2021 Published online: November 22, 2021
Abstract
Bacteria of the human intestinal microflora have a dual role. They promote digestion and are part of a defense mechanism against pathogens. These bacteria could become potential pathogens under certain circumstances. The term “bacterial translocation” describes the passage of bacteria of the gastrointestinal tract through the intestinal mucosa barrier to mesenteric lymph nodes and other organs. In some cases, the passage of bacteria and endotoxins could result in blood stream infections and in multiple organ failure. Open elective abdominal surgery more frequently results in malfunction of the intestinal barrier and subsequent bacterial translocation and blood stream infections than laparoscopic surgery. Postoperative sepsis is a common finding in patients who have undergone non-elective abdominal surgeries, including trauma patients treated with laparotomy. Postoperative sepsis is an emerging issue, as it changes the treatment plan in surgical patients and prolongs hospital stay. The association between bacterial translocation and postoperative sepsis could provide novel treatment options.
Core Tip: Increased intestinal permeability can potentially induce intestinal flora dysbiosis. Bacterial translocation, attributed to intestinal barrier impairment, may lead to systematic infection in the postoperative period. The definitive correlation between translocation and postoperative sepsis is yet to be proven, but the latter is an emerging issue for patients undergoing major gastrointestinal surgeries.
