Main Article Content
Preoperative Probiotic Use, Colorectal Surgery, Complications
Aim: Colorectal cancers are prevalent around the world. There may be some complications after cancer related surgeries. This study aims to identify whether the use of probiotics in preoperative period among the patients undergone colorectal cancer surgery diminishes postoperative complications.
Material and Method: Within the framework of this prospective observational study, the patients, who had colorectal cancer surgery and used probiotics for 5-7 days in preoperative period, were categorised as Group P and the patients, who did not used any probiotics as Group C. The complications in postoperative period and their length of hospital stay were analysed respectively. The patients were followed-up in terms of major complications such as anastomotic leak, anastomotic stricture, surgical site infection, wound infection, wound dehiscence, lung infections, respiratory distress and embolism.
Findings: A total number of 40 patients were covered under the study. The patients using preoperative probiotics did not develop any anastomotic leak while 4 patients (20%) from the group that did not use any probiotics developed anastomotic leak (p=0,03). With regard to the correlation of probiotics use, there has been a decline of 30% in postoperative wound infection (10% vs. 40%, p<0,028) and of 45% in lung problems (20% vs. 65%, p=0,004). Postoperative ileus was observed 35% less in Group P than Group K. Additionally, the average of hospital stays in such patients diminished at significant level (17,6±7,3 days vs 8,8±2,6, p<0,001).
Conclusion: The use of probiotics in colorectal cancer surgery patients during preoperative period significantly diminishes infectious complications, rate of anastomotic leak incidence and length of hospital stays. It is possible to interpret that the use of probiotics that does not have any apparent side effects in preoperative period reduces the postoperative complications.
2. Zhi-Hua Liu, Mei-Jin Huang, Xing-Wei Zhang, Lei Wang, Nan-Qi Huang, Hui Peng,The effects of perioperative probiotic treatment on serum zonulin. Am J Clin Nutr 2013;97:117–26.
3. Kanazawa H, Nagino M, Kamiya S, Komatsu S, Mayumi T, Takagi K, Asahara T, Nomoto K, Tanaka R, Nimura Y. Synbiotics reduce postoperative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy. Langenbecks. Langenbecks Arch Surg 2005;390:104–13..
4. Correia MI, Liboredo JC, Consoli ML. The role of probiotics in gastrointestinal surgery. Nutrition 2012;28(3):230–4.
5. Jeppsson, B., Mangell, P., & Thorlacius, H.. Use of probiotics as prophylaxis for postoperative infections. Nutrients, (2011),3(5), 604-12.
6. Jijon H, Backer J, Diaz H, et al. DNA from probiotic bacteria modulates murine and human epithelial and immune function. Gastroenterology 2004; 126:1358–73.
7. Quigley EMM, Quera R. Small intestinal bacterial overgrowth: roles of antibiotics, prebiotics and probiotics. Gastroenterology 2006; 130:78-90.
8. Gionchetti P, Amadini C, Rizzello F, et al. Probiotics for the treatment of postoperative complications following intestinal surgery. Best Pract Res Clin Gastroenterol 2003; 17:821–31.
9. Bengmark S. Bio-ecological control of peri-operative and ITU morbidity. Langenbecks Arch Surg 2004; 389:145–54.
10. Seehofer D, Rayes N, Schiller R, et al. Probiotics partly reverse increased bacterial translocation after simultaneous liver resection and colonic anastomosis in rats. J Surg Res 2004; 117:262–71.
11. Dock DB, Aguilar-Nascimento JE, Latorraca MQ, Gomes da Silva MHG. Probiotics improve the recovery of malnutrition and lessen colonic mucosal atrophy after short term fasting in rats. Nutrition 2004; 20:473–76.
12. Lu MC, Yang MD, Chen W, Wu LT. Probiotic Lactobacillus rhamnosus can promote gastrointestinal functions effectively and safely in humans. Clin Nutr 2004; 23:856–57.
13. American Thoracic Society: Guidelines for the management of adult with hospital acquired, ventilator-associated and healthcare-associated pneumonia, Am J Respir Crit Care Med 2005; 171(4):388-416.
14. Fisher BW, Majumdar SR, McAlister FA: Predicting pulmonary complications after nonthoracic sur¬gery: a systematic review of blinded studies, Am J Med 2002;112(3):219-25.
15. Lawrence VA, Hilsenbeck S, Mulrow C, Ohanda R, Sapp J, Page CP: Incidence and hospital stay for cardiac and pulmonary complications after abdomi¬nal surgery, J Gen Intern Med 1995;10(12): 671-8.
16. He D, Wang HY, Feng JY et al (2013) Use of pro-/synbiotics as prophylaxis in patients undergoing colorectal resection for cancer: a meta-analysis of randomized controlled trials. Clin Res Hepatol Gastroenterol 37:406–15.
17. MU Y, Edwards JR, Horan TC, Berios-Torres SI,Fridkin SK, Improving risk-adjusted measures of surgicel site infection for the National Helthcare Safety Network. Infect Kontrol Hosp Epidemiol 2011;32:970-86.
18. Rayes N, Hansen S, Seehofer D, et al. Early enteral supply of fiber and lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery. Nutrition 2002; 18:609–15.
19. Katerina K., George S., Georgia D.,Marianna G.,George B., Georgia T., et al. A Four Probiotics Regimen Reduces Postoperative Complications After Colorectal Surgery: A Randomized, Double-Blind, Placebo-Controlled Study. World J Surg.2015,39(11); 2784-5.
20. Z. Liu, H. Qin, Z. Yang, Y. Xia, W. Liu, J. Yang, et al. Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post-operative infectious complications in colorectal cancer surgery – a double-blind study. Aliment Pharmacol Ther 2011; 33: 50–63,