Exploring the roles of intestinal flora in enhanced recovery after surgery

Zaoqu Liu; Na Li; Qin Dang; Long Liu; Libo Wang; Huanyun Li; Xinwei Han

doi:10.1016/j.isci.2023.105959

Exploring the roles of intestinal flora in enhanced recovery after surgery

iScience. 2023 Jan 13;26(2):105959. doi: 10.1016/j.isci.2023.105959. eCollection 2023 Feb 17.

Authors

Zaoqu Liu^{1

2

3}, Na Li⁴, Qin Dang⁵, Long Liu⁶, Libo Wang⁶, Huanyun Li⁷, Xinwei Han^{1

2

3}

Affiliations

¹ Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.
² Interventional Institute of Zhengzhou University, Zhengzhou, Henan 450052, China.
³ Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, Henan 450052, China.
⁴ Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.
⁵ Department of Colorectal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.
⁶ Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.
⁷ Genetic and Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.

Abstract

Striving to optimize surgical outcomes, the Enhanced Recovery After Surgery (ERAS) pathway mitigates patients' stress through the implementation of evidence-based practices during the pre-, intra-, and postoperative periods. Intestinal flora is a sophisticated ecosystem integrating with the host and the external environment, which serves as a mediator in diverse interventions of ERAS to regulate human metabolism and inflammation. This review linked gut microbes and their metabolites with ERAS interventions, offering novel high-quality investigative proponents for ERAS. ERAS could alter the composition and function of intestinal flora in patients by alleviating various perioperative stress responses. Modifying gut flora through multiple modalities, such as diet and nutrition, to accelerate recovery might be a complementary approach when exploring novel ERAS initiatives. Meanwhile, the pandemic of COVID-19 and the availability of promising qualitative evidence created both challenges and opportunities for the establishment of ERAS mode.

Keywords: Medicine; Microbiology; Microbiome; Surgery.

Publication types

Review