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Framework of the gut microbiota and anastomotic leak (AL) presented in three levels. Level 1: factors that contribute to the gut microbiota; level 2: how pathogenic or collagenase bacteria adhere to the intestinal mucosa and avoid host clearance; and level 3; the mechanism by which AL-related gut bacteria interact with the host intestinal epithelial and mesenchymal cells, then affecting anastomotic healing.
