“The invisible enemy: Gut microbiota and their role in anastomotic leak”

Anastomotic leak is a devastating complication of gastrointestinal surgery that is associated with high morbidity and mortality. Yet, despite flawless technique in the operating room, many anastomoses still leak, suggesting that factors beyond tension and ischemia contribute to anastomotic leak. In this article, we will review the accumulating evidence that the gut microbiome plays a critical role in anastomotic healing, and then review methods of minimizing perturbances to the gut microbiome to decrease rates of anastomotic leak.