ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2016
Morphine Promotes Colonization of Anastomotic Tissues with Collagenase - Producing Enterococcus faecalis and Causes Leak.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Esophageal microbiota composition and outcome of esophageal cancer treatment: a systematic review.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2022Pooled it
- Modulation of the gut microbiota as a novel strategy to prevent anastomotic leak after colorectal surgery: Systematic scoping review.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- Natural and synthetic chemicals acting as enhancers of bacterial pathogenic success within the human host.Frontiers in cellular and infection microbiology · 2026Review
- Reducing Postoperative Opioid Use: A Comparison of Open Versus Ultrasound-Guided Regional Anesthesia for Patients Undergoing Open Pancreatoduodenectomy.Journal of surgical oncology · 2025Article
- Impact of gut microbiota on colorectal anastomotic healing (Review).Molecular and clinical oncology · 2025Review
- Exploring correlation between preoperative gut microbiota and PONV using 16S absolute quantitative sequencing: a prospective observational study.Frontiers in medicine · 2025Article
- Microbiota profiling in esophageal diseases: Novel insights into molecular staining and clinical outcomes.Computational and structural biotechnology journal · 2024Review
- What Is the Role of the Gut Microbiota in Anastomotic Leakage After Colorectal Resection? A Scoping Review of Clinical and Experimental Studies.Journal of clinical medicine · 2024Article
- Impact of opioid-related disorders on complications in patients undergoing bariatric surgery: a propensity score-matched analysis of the national inpatient sample.Surgical endoscopy · 2024Article
- The Combined Effect of Western Diet Consumption and Diclofenac Administration Alters the Gut Microbiota and Promotes Anastomotic Leakage in the Distal Colon.Biomedicines · 2024Article
- Perioperative Considerations for the Surgical Treatment of Crohn's Disease with Discussion on Surgical Antibiotics Practices and Impact on the Gut Microbiome.Antibiotics (Basel, Switzerland) · 2024Review
- Selective Decontamination with Oral Antibiotics in Colorectal Surgery: 90-day Reintervention Rates and Long-term Oncological Follow-up.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- The Influence of the Microbiome on Anastomotic Leak.Clinics in colon and rectal surgery · 2023Review
- Review
- The Colorectal Anastomosis: A Timeless Challenge.Clinics in colon and rectal surgery · 2023Review
- Opioid-Use, COVID-19 Infection, and Their Neurological Implications.Frontiers in neurology · 2022Review
- Influence of the Microbiome on Anastomotic Leak.Clinics in colon and rectal surgery · 2021Review
- The effect of opioids on gastrointestinal function in the ICU.Critical care (London, England) · 2021Review
- The gut microbiota and colorectal surgery outcomes: facts or hype? A narrative review.BMC surgery · 2021Review
- Intestinal Microbiota in Colorectal Cancer Surgery.Cancers · 2020Review
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundDespite ever more powerful antibiotics, newer surgical techniques, and enhanced recovery programs, anastomotic leaks remain a clear and present danger to patients. Previous work from our laboratory suggests that anastomotic leakage may be caused by Enterococcus faecalis strains that express a high collagenase phenotype (i.e., collagenolytic). Yet the mechanisms by which the practice of surgery shifts or selects for collagenolytic phenotypes to colonize anastomotic tissues remain unknown.
methodsHere, we hypothesized that morphine, an analgesic agent universally used in gastrointestinal surgery, promotes tissue colonization with collagenolytic E. faecalis and causes anastomotic leak. To test this, rats were administered morphine in a chronic release form as would occur during routine surgery or vehicle. Rats were observed for 6 days and then underwent exploratory laparotomy for anastomotic inspection and tissue harvest for microbial analysis. These results provide further rationale to enhanced recovery after surgery (i.e., ERAS) programs that suggest limiting or avoiding the use of opioids in gastrointestinal surgery.
resultsResults demonstrated that compared to placebo-treated rats, morphine-treated rats demonstrated markedly impaired anastomotic healing and gross leaks that correlated with the presence of high collagenase-producing E. faecalis adherent to anastomotic tissues. To determine the direct role of morphine on this response, various isolates of E. faecalis from the rats were exposed to morphine and their collagenase activity and adherence capacity determined in vitro. Morphine increased both the adhesiveness and collagenase production of four strains of E. faecalis harvested from anastomotic tissues, two that were low collagenase producers at baseline, and two that were high collagenase producers at baseline.
conclusionThese results provide further rationale to enhanced recovery after surgery (i.e., ERAS) programs that suggest limiting or avoiding the use of opioids in gastrointestinal surgery.
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