The effect of perioperative probiotics treatment for colorectal cancer: short-term outcomes of a randomized controlled trial

Abstract

This study was designed to mainly evaluate the anti-infective effects of perioperative probiotic treatment in patients receiving confined colorectal cancer (CRC) respective surgery. From November 2011 to September 2012, a total of 60 patients diagnosed with CRC were randomly assigned to receive probiotic (n = 30) or placebo (n = 30) treatment. The operative and post-operative clinical results including intestinal cleanliness, days to first - flatus, defecation, fluid diet, solid diet, duration of pyrexia, average heart rate, length of intraperitoneal drainage, length of antibiotic therapy, blood index changes, rate of infectious and non-infectious complications, postoperative hospital stay, and mortality were investigated. The patient demographics were not significantly different (p > 0.05) between the probiotic treated and the placebo groups. The days to first flatus (3.63 versus 3.27, p = 0.0274) and the days to first defecation (4.53 versus 3.87, p = 0.0268) were significantly improved in the probiotic treated patients. The incidence of diarrhea was significantly lower (p = 0.0352) in probiotics group (26.67%, 8/30) compared to the placebo group (53.33%, 16/30). There were no statistical differences (p > 0.05) in other infectious and non-infectious complication rates including wound infection, pneumonia, urinary tract infection, anastomotic leakage, and abdominal distension. In conclusion, for those patients undergoing confined CRC resection, perioperative probiotic administration significantly influenced the recovery of bowel function, and such improvement may be of important clinical significance in reducing the short-term infectious complications such as bacteremia.

Efficacy of prophylactic probiotics in combination with antibiotics versus antibiotics alone for colorectal surgery: A meta‐analysis of randomized controlled trials

“…The prophylactic probiotics were mostly Lactobacillus (10/14) and Bifidobacterium (12/15) based, while the preoperative antibiotics prophylaxis regimens varied across studies. Despite all studies performed mechanical bowel preparation, only one study applied oral antibiotics, one study applied both oral and intravenous infusion of antibiotics, and most of the studies used intravenous infusion of cephalosporins plus metronidazole, one used intravenous infusion of gentamicin plus metronidazole, and three studies used intravenous infusion of cephalosporins alone . Most trials conducted power calculation (13/14), many did not apply intention‐to‐treat analysis (11/14) …”

Probiotics as a preventive strategy for surgical infection in colorectal cancer patients: a systematic review and meta-analysis of randomized trials

“…For this purpose, the present study evaluated the prophylactic and therapeutic effects of probiotics on patients with CRC in the pre-and postoperative, and at the same time searched for preventive strategies from recent experimental models. A large number of studies have shown that probiotics can prevent the initiation or development of cancer by changing the intestinal microbial composition, host protection against pathogenic bacteria and fungi, the production of biological substances such as short-chain fatty acid and conjugated linoleic acid, inactivation of carcinogenic compounds, improvement of gut barrier function, modulation of immune responses, apoptosis, anti-proliferative effects and antioxidant activity (21)(22)(23) (18) observed better outcomes by using these microorganisms in the therapeutic intervention for patients with CRC. Perioperative administration of probiotics reduces the inflammatory response, which can lead to a reduction in length of hospital stay.…”

“…A total of 4 of 6 articles evaluated showed a positive response of the probiotic use (4,5,9,18), while 2 of them showed a placebo response (2,19).…”

“…Pitsouni et al (29) reported that the use of probiotics and symbiotics in patients submitted to CRC surgery is a very promising clinical measure for the prevention of postoperative infectious complications. However, it appears that the outcome of the treatment depends on the genus (2,(4)(5)(6)9,18,19 of bacteria, the number of bacteria administered and the number of viable probiotic bacteria that reach and colonize the colon (30).…”

Uso De Pré, Pró E Simbióticos Como Coadjuvantes No Tratamento Do Câncer Colorretal

“…O uso de probióticos e prebióticos diminui o risco de complicações pós-operatórias, como septicemia 22,28 , ventilação mecânica, infecções, pneumonia e vazamento da anastomose 25,26 , além de trazer benefícios clínicos em curto prazo através da recuperação mais rápida da função intestinal, com menor incidência de diarreia e alta hospitalar mais rápida 26,30 . Além disso, o uso de probióticos e prebióticos auxilia na manutenção da resistência à colonização microbiana por microrganismos indesejáveis e restringe a translocação bacteriana no intestino.…”