Microbiome profile between non-surgical, Roux-en-Y, and end-to-end anastomosis intestinal regions. Mouse intestinal samples

Anastomotic failure causes morbidity and mortality even in technically correct anastomoses. Initial leaks must be prevented by mucosal reapproximation across the anastomosis. Healing is a concerted effort between intestinal epithelial cells (IECs), immune cells, and commensal bacteria. IEC TLR4 activation and signaling is required for mucosal healing, leading to inflammatory factor release that recruits immune cells to limit bacteria invasion. TLR4 absence leads to mucosal damage from loss in epithelial proliferation, attenuated inflammatory response, and bacteria translocation. We hypothesize after anastomosis, an imbalance in microbiota will impede TLR4 expression and impair crosstalk with the immune milieu. We isolated small intestinal leukocytes and fecal content from murine, Roux-en-Y and end-to-end anastomoses, to identify regulatory and pro-inflammatory immune cells and microbiome changes 3 days post-operative.