Perioperative probiotic treatment decreased the incidence of postoperative cognitive impairment in elderly patients following non-cardiac surgery: A randomised double-blind and placebo-controlled trial

Wang, Pingzhu; Yin, Xinlin; Chen, Gong; Li, Lan; Yuan, Long; Xie, Zhongcong; Ouyang, Wen; Tong, Jianbin

doi:10.1016/j.clnu.2020.05.001

Cited by 47 publications

(45 citation statements)

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“…The flow diagram ( Figure 1 ) of trials shows the inclusion/exclusion processes. Twenty-one RCTs were eventually included in the synthesis [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. Table 1 summarises the characteristics of included RCTs.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 6 RCTs evaluated synbiotics [ 24 , 25 , 30 , 34 , 38 , 40 ], and 15 evaluated probiotics [ 26 , 27 , 28 , 29 , 31 , 32 , 33 , 35 , 36 , 37 , 39 , 41 , 42 , 43 , 44 ]. The control group received a placebo ( n = 14) [ 25 , 26 , 27 , 28 , 29 , 32 , 36 , 37 , 38 , 39 , 40 , 42 , 43 , 44 ] or standard care ( n = 7) [ 24 , 30 , 31 , 33 , 34 , 35 , 41 ]. A total of 8 RCTs involved a preoperative timing for probiotic or synbiotic [ 24 , 25 , 28 , 30 , 33 , 36 , 39 , 40 ], 10 both pre- and postoperative timing [ …”

Section: Resultsmentioning

confidence: 99%

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Probiotics/Synbiotics to Reduce Infectious Complications after Colorectal Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

et al. 2022

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Aim: The aims of this systematic review and meta-analysis were to assess to what extent probiotics/synbiotics reduce infectious complications after colorectal surgery and whether probiotics or synbiotics should be considered as perioperative measures preventing or reducing infectious complications after CRS and should be included in enhanced recovery programmes (ERP). Secondary aims were to answer practical questions precisely on the best formulation and the type and timing of probiotics or synbiotics in CRS. Method: This systematic review and quantitative meta-analysis were conducted in accordance with PRISMA 2020 guidelines. Inclusion criteria were randomised trials comparing perioperative probiotics/synbiotics with a placebo or standard care in elective colorectal surgery. Exclusion criteria were non-randomised trials. Overall infectious complications and surgical site infections (SSIs including both deep abdominal infections and wound (skin or under the skin) infections) were the primary outcomes. Secondary outcomes were pulmonary and urinary infections, wound infections, and anastomotic leaks. The databases consulted were Medline, Cochrane Database of Systematic Reviews, Scopus, and Clinical Trials Register. Risk of bias was assessed according to the GRADE approach. The analysis calculated the random effects estimates risk ratio (RR) for each outcome. Results: 21 trials were included; 15 evaluated probiotics, and 6 evaluated synbiotics. There were significantly fewer infectious complications (risk ratio (RR) 0.59 [0.47–0.75], I2 = 15%) and fewer SSI (RR 0.70 [0.52–0.95], I2 = 0%) in the probiotic or synbiotic group. There were also significantly fewer pulmonary infections (RR 0.35 [0.20–0.63]) and urinary infections RR 0.41 [0.19–0.87]) as opposed to anastomotic leaks (RR 0.83 [0.47–1.48]) and wound infections (RR 0.74 [0.53–1.03]). Sensitivity analyses showed no significant difference between probiotics and synbiotics in reducing postoperative infections (RR 0.55 [0.42–0.73] versus RR 0.69 [0.42–1.13], p = 0.46). Conclusions: Based on the finding of this study, probiotics/synbiotics reduce infectious complications after colorectal surgery. The effect size was more pronounced for pulmonary and urinary infections. From a practical aspect, some of the questions related to formulations and duration of probiotics or synbiotics need to be answered before including them definitively in enhanced recovery after colorectal surgery programmes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Probiotics/Synbiotics to Reduce Infectious Complications after Colorectal Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

et al. 2022

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“… 55 - 57 For instance, in women with breast cancer who had previously completed chemotherapy, lower alpha diversity and relative abundance of Firmicutes and higher relative abundance of Bacteroidetes was significantly associated with fear of cancer recurrence compared to women who had not received chemotherapy. 56 Additionally, Wang et al 58 found a reduction in postoperative cognitive impairment and plasma IL-6 and cortisol levels following treatment with oral probiotics, compared to a placebo control group, in elderly patients following elective orthopedic or colorectal cancer surgery. Microbiota-based therapies hold promise for novel treatments to prevent or reduce treatment-related side effects and improve patients QOL.…”

Section: Discussionmentioning

confidence: 99%

The Use of Prebiotic and Probiotic Interventions for Treating Gastrointestinal and Psychosocial Health Symptoms in Cancer Patients and Survivors: A Systematic Review

et al. 2021

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Background: Cancer treatments can cause significant gastrointestinal (GI) health issues, and negatively affect patient’s psychosocial health and quality of life (QOL). Novel, integrative strategies using prebiotics and probiotics have been explored for treating adverse cancer treatment-related side effects. We evaluated the current literature for interventions using prebiotics or probiotics specifically to treat GI and psychosocial health issues in cancer patients and survivors. Methods: Five databases (PubMed, MEDLINE (Ovid), CINHAL, PsychINFO, Web of Science) were searched for studies with prebiotic or probiotic interventions where GI and/or psychosocial health outcomes were measured in adult cancer patients and survivors, and published before September 12th 2021. Results: Twelve studies (N = 974 participants) meeting the inclusion criteria were identified (randomized controlled trials [n = 10], single-group pre-post studies [n = 2]). Ten studies were conducted with patients on active cancer treatment, and 2 studies treated patients after anti-cancer therapies. Three studies used prebiotics, 7 studies used probiotics, and 2 studies used a combination therapy. The most commonly used probiotic strains were from the Lactobacillus genus. There was minimal evidence for prebiotics to improve GI or psychosocial health. Probiotics were associated with significant improvements in abdominal pain (n = 2), gas/bloating (n = 2), and especially diarrhea (n = 5), and with improvements in anxiety (n = 1), depression (n = 1), fatigue (n = 1), and QOL (n = 2). Conclusions: Studies specifically examining effects of prebiotics and probiotics on GI and psychosocial health outcomes are scarce. Probiotic intervention may improve some GI symptoms in cancer patients, and QOL in survivors. Controlled trials that consistently include GI and psychosocial health outcomes are needed.

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“…Recently, a randomized double-blind and placebo-controlled trial comprising 120 elderly patients following elective orthopedic or colorectal cancer surgery found an association between the perioperative application of oral probiotics and postoperative reduction in cognitive impairment. In addition, increased microbiota diversity and decrease plasma IL-6 and cortisol levels were observed in the group of probiotic patients suggesting a possible mechanism via reducing the peripheral inflammation, and the stress response [167]. Interestingly, the probiotic intervention was found to reduce the clinical anxiety before surgery by the suppression of serum corticotropin-releasing factor levels and avoiding the increase in heartbeat among patients with laryngeal cancer [168].…”

Section: Neuro-and Cardioprotective Effect Of Probioticsmentioning

confidence: 98%

Exploring the Potential Role of the Gut Microbiome in Chemotherapy-Induced Neurocognitive Disorders and Cardiovascular Toxicity

Ciernikova

Mego

Chovanec

2021

Cancers

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Chemotherapy, targeting not only malignant but also healthy cells, causes many undesirable side effects in cancer patients. Due to this fact, long-term cancer survivors often suffer from late effects, including cognitive impairment and cardiovascular toxicity. Chemotherapy damages the intestinal mucosa and heavily disrupts the gut ecosystem, leading to gastrointestinal toxicity. Animal models and clinical studies have revealed the associations between intestinal dysbiosis and depression, anxiety, pain, impaired cognitive functions, and cardiovascular diseases. Recently, a possible link between chemotherapy-induced gut microbiota disruption and late effects in cancer survivors has been proposed. In this review, we summarize the current understanding of preclinical and clinical findings regarding the emerging role of the microbiome and the microbiota–gut–brain axis in chemotherapy-related late effects affecting the central nervous system (CNS) and heart functions. Importantly, we provide an overview of clinical trials evaluating the relationship between the gut microbiome and cancer survivorship. Moreover, the beneficial effects of probiotics in experimental models and non-cancer patients with neurocognitive disorders and cardiovascular diseases as well as several studies on microbiota modulations via probiotics or fecal microbiota transplantation in cancer patients are discussed.

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Perioperative probiotic treatment decreased the incidence of postoperative cognitive impairment in elderly patients following non-cardiac surgery: A randomised double-blind and placebo-controlled trial

Cited by 47 publications

References 46 publications

Probiotics/Synbiotics to Reduce Infectious Complications after Colorectal Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Probiotics/Synbiotics to Reduce Infectious Complications after Colorectal Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

The Use of Prebiotic and Probiotic Interventions for Treating Gastrointestinal and Psychosocial Health Symptoms in Cancer Patients and Survivors: A Systematic Review

Exploring the Potential Role of the Gut Microbiome in Chemotherapy-Induced Neurocognitive Disorders and Cardiovascular Toxicity

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