Effects of PrObiotics on the Symptoms and Surgical ouTComes after Anterior REsection of Colon Cancer (POSTCARE): A Randomized, Double-Blind, Placebo-Controlled Trial

Abstract

<jats:p>We investigated microbiota changes following surgical colon cancer resection and evaluate effects of probiotics on microbiota and surgical recovery. This randomized double-blind trial was performed at four medical centers in South Korea. Of 68 patients expected to undergo anterior sigmoid colon cancer resection, 60 were eligible, of whom 29 and 31 received probiotics and placebo, respectively, for four weeks, starting at one week preoperatively. Third- and/or fourth-week information on anterior resection syndrome (ARS), inflammatory markers, and quality of life was obtained. Stool sample analysis was conducted after randomization and bowel preparation and at three and four postoperative weeks. Bacteria were categorized into Set I (with probiotic effects) and II (colon cancer-associated). The probiotic group’s ARS score showed an improving trend (p = 0.063), particularly for flatus control (p = 0.030). Serum zonulin levels significantly decreased with probiotics. Probiotic ingestion resulted in compositional changes in gut microbiota; greater increases and decreases in Set I and II bacteria, respectively, occurred with probiotics. Compositional increase in Set I bacteria was associated with reduced white blood cells, neutrophils, neutrophil-lymphocyte ratio, and zonulin. Bifidobacterium composition was negatively correlated with zonulin levels in the probiotic group. Probiotics improved postoperative flatus control and modified postoperative changes in microbiota and inflammatory markers.</jats:p>

Probiotics Evaluation in Oncological Surgery: A Systematic Review of 36 Randomized Controlled Trials Assessing 21 Diverse Formulations

“…Searches for the overarching umbrella project of 10 natural health products retrieved 4653 records in total, which were screened in duplicate. A total of 45 probiotics articles were included, reporting on 42 unique studies, comprising 39 reports (listed alphabetically under the References) [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 ], of 36 randomized controlled trials involving 3305 participants and 6 nonrandomized and cohort studies [ 72 , 73 , 74 , 75 , 76 , 77 ]. A study flow diagram is presented in Figure 1 .…”

“…This trial in sigmoid colon cancer utilized Bifidobacterium animalis subsp. lactis HY8002 + Lactobacillus casei HY2782 + L. plantarum HY7712 + xylooligosaccharides + fructooligosaccharides [ 54 ]. Other postoperative complications not captured above are also presented for additional safety data ( Table S5 ).…”

The Functional Properties of Lactobacillus casei HY2782 Are Affected by the Fermentation Time

“…L. casei HY2782 is used as a starter strain for Korean Yakult fermented milk products. Previous studies have shown that L. casei HY2782 has various functions such as increasing the expression of interleukin 12 in dendritic cells [18] and preventing the toxic effect induced by particulate matter [19,20]. Previous studies found that growth and metabolism mostly cease after 24 h of incubation.…”

Prophylactic effects of probiotics or synbiotics on postoperative ileus after gastrointestinal cancer surgery: A meta-analysis of randomized controlled trials

“…Ten of the studies [ 16 , 22 , 23 , 27 – 29 , 31 , 32 , 34 , 36 ] conducted an appropriate randomization process. Deviations from intended interventions were evaluated as a low bias risk in six studies [ 16 , 20 , 22 , 31 , 34 , 36 ].…”

“…Ten of the studies [ 16 , 22 , 23 , 27 – 29 , 31 , 32 , 34 , 36 ] conducted an appropriate randomization process. Deviations from intended interventions were evaluated as a low bias risk in six studies [ 16 , 20 , 22 , 31 , 34 , 36 ]. Missing outcome data, measurement of the outcome, and selection of the reported result in all studies were assessed as a low bias risk ( Fig 2 ).…”